• Title/Summary/Keyword: clinical guideline

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Pediatric Severe Traumatic Brain Injury : Updated Management

  • Ha, Eun Jin
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.354-360
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    • 2022
  • Traumatic brain injury (TBI) is the leading cause of death and disability in children. Survivors of severe TBI are more susceptible to functional deficits, resulting in disability, poor quality of life, cognitive decline, and mental health problems. Despite this, little is known about the pathophysiology of TBI in children and how to manage it most effectively. Internationally, efforts are being made to expand knowledge of pathophysiology and develop practical clinical treatment recommendations to improve outcomes. Here we discuss recently updated evidence and management of severe pediatric TBI.

Quality indicators in esophagogastroduodenoscopy

  • Sang Yoon Kim;Jae Myung Park
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.319-331
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    • 2022
  • Esophagogastroduodenoscopy (EGD) has been used to diagnose a wide variety of upper gastrointestinal diseases. In particular, EGD is used to screen high-risk subjects of gastric cancer. Quality control of EGD is important because the diagnostic rate is examiner-dependent. However, there is still no representative quality indicator that can be uniformly applied in EGD. There has been growing awareness of the importance of quality control in improving EGD performance. Therefore, we aimed to review the available and emerging quality indicators for diagnostic EGD.

Switch to Olanzapine from Clozapine or Risperidone and 12-months Follow Up (Clozapine과 Risperidone에서 Olanzapine으로 교체 연구 : 12개월 추적연구)

  • Cho, Bang Hyun;Jung, In Kwa;Paik, Jong Woo
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.140-146
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    • 2001
  • In clinical setting, treatment-refractoriness, medication induced tardive dyskinesia and amenorrhea in chronic schizophrenia are frequently problematic. However, there are few guideline solving these problem available to clinicians. The goal of this study was collecting clinical data on clinical effectiveness and predictors of response of switching to olanzapine. We attempted to switch to olanzapine from risperidone and clozapine in chronic 31(risperidone 17, clozapine 14) schizophrenia and schizoaffective disorder patients suffering from sustained symptoms, weekly blood monitoring, medication induced tardive dyskinesia and amenorrhea. Previous antipsychotics dosage was gradually decreased for 2 or 3weeks, at the same time olanzapine dosage was gradually increased. At baseline, after 1 week, after 2 weeks and after 4 weeks we checked Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Sympson-Angus Rating Scale, Barnes Akathisia Rating Scale and followed up after 12 months. Successful switch after 4 weeks was achieved in 25 patients(clozapine 9(64.2%), risperidone 16(94.1%)). Overall, mean BPRS and CGI scores increased significantly. Successful maintenance after 12 months was achieved in 17 patients(clozapine 5(35.7%), risperidone 12(70.5%)). Overall, mean BPRS and CGI scores increased significantly too. Switching to olanzapine from other atypical antipsychotics is recommendable in chronic schizophrenia with treatment refractoriness and drug induced side effect.

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Systematic Review of Selection of Acupoints in Domestic Clinical Studies Related to Nuchal Pain (국내 경항통 연구에서의 경혈 선정에 관한 계통적 연구)

  • Lee, Hyung Eun;Lee, Eun Jung;Oh, Min Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.6
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    • pp.698-704
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    • 2013
  • The purpose of this study is to figure out which acupoints are selected to treat nuchal pain and attempt to analyze the meaning of those acupoints in current clinical trials. We searched ten electronic databases and manually checked related Korean journals and references. We included randomized controlled trials(RCT), clinical controlled trials(CCT), case reports/series, and literature reviews using acupojnts to treat nuchal pain. We investigated the frequency of selected acupoints. We included 31 articles in this study. The most frequently adopted acupoints were GB20(77.41%), followed by GB21(61.29%). In distribution according to meridian system, BL was the most(25.60%), followed by Extra points of Dong-Shi(12.19%). Selected acupoints for treat nuchal pain were considered to be affected by flow of meridian system. It is necessary for more studies to provide clinical guideline of acupoint selection.

Clinical Reference of the Maximum Standardized Uptake Values to the Pancreatic Cancer, Pancreatitis and Normal Pancreas in the 18F-FDG PET-CT (18F-FDG PET-CT 검사에서 췌장암, 췌장염, 정상 췌장에 대한 최대 표준섭취계수의 임상적 기준 설정)

  • Lee, Jae-Seung;Kweon, Dae Cheol
    • Journal of Biomedical Engineering Research
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    • v.39 no.2
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    • pp.80-86
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    • 2018
  • The aim of this study were to establish the clinical references and guidelines for the maximum standardized uptake ($SUV_{max}$) value of pancreatic cancer, pancreatitis, and normal pancreas in $^{18}F-FDG$ PET-CT examinations for pancreatic disease. For this purpose, we performed the statistical analysis on the descriptive statistics, percentiles and inter quartiles range (IQR), normal distribution, and using the probability density function for pancreatic cancer, pancreatitis, and normal pancreas. As a result, the clinical reference of $SUV_{max}$ for the pancreatic cancer, pancreatitis, and normal pancreas was more than 3.45, 1.91 to 2.62, and less than 1.91, respectively. Also, optimal cut-off value for applying the dual time point PET-CT examination was determined to be 2.62. The results of this study are summarized as follows: first, we suggests the clinical reference and guideline for the pancreatic cancer, pancreatitis, and normal pancreas, and second, suggests a scientific approach to improve diagnostic accuracy of pancreatic disease by deviating from an approximate experience approach.

Assessment of the Quality of Case Reports in the Journal of Acupuncture Research Using the CARE and STRICTA Guidelines

  • Nam, Eun-Young;Hwang, Ji Hye
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.224-232
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    • 2020
  • The purpose of this study was to assess the quality of the case reports in the Journal of Acupuncture Research (JAR). All case reports were retrieved from November 2017 to June 2020. There were 19 case reports included in this assessment based on the case report (CARE) guidelines and case report and standards for reporting interventions in clinical trials of acupuncture (STRICTA) guidelines. The overall quality of reporting was relatively high (83.08% on Case Report guidelines and 77.78% on Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines), but several crucial items remained substantially underreported, such as identifying as a case report (keywords), patient information and perspective, clinical findings, diagnostic assessment, and intervention information. In 18 out of 19 included case reports of acupuncture-related interventions, several items remained considerably underreported such as acupuncture regimen variation, depth of needle insertion, response sought, and experience of acupuncturists. In the classification by disease, condition, or syndrome, 13 out of 19 included case reports were for musculoskeletal disorders (68.4%), which is the main clinical medical field of Korean medicine services. The results of this study may help develop more appropriate reporting guidelines for case reports published in JAR.

A Comparative Study of USA and Europe Guidelines of Rate and Rhythm Control Pharmacotherapy in Atrial Fibrillation (심방세동 치료를 위한 미국과 유럽의 심박수 및 율동 조절 약물요법 가이드라인 비교 연구)

  • Jung, Eun Joo;Sohn, KieHo;Baek, In-Hwan
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.84-95
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    • 2016
  • Objective: Atrial fibrillation (AF) guidelines have been published in the USA and Europe. Recently, the USA and Europe have updated their guidelines, respectively. These new AF guidelines help in addressing key management issues in clinical situations. This study, therefore, systematically compared guidelines for rate and rhythm control pharmacotherapy of patients with AF between the USA (American College of Cardiology and American Heart Association, ACC/AHA) and Europe (European Society of Cardiology, ESC). Methods: This study investigated and compared American guidelines (2014) and European guidelines (2010 and 2012). Results: Generally, there are four meaningful differences between ACC/AHA and ESC guidelines. Important differences are treatment classification system, level of recommendation, drug list, and dosage. In addition, ACC/AHA described pharmacokinetic drug interactions for antiarrhythmic drugs. ESC emphasized ECG and atrioventricular nodal slowing as feature of antiarrhythmic drugs. Conclusion: This research addresses important use of anti-arrhythmic drugs and movement to accept recent recommendations in Korea. For the successful application of the guidelines, a role of pharmacists is crucial in clinical situation.

Usage of Korean Herbal Medicine for Climacteric Symptoms - Analysis of Korean Clinical Studies (갱년기 증상에 대한 한약 사용 - 국내 한의 임상연구 분석)

  • Minjung Bae;Jaewoon Ha;Youngju Yun
    • Journal of Society of Preventive Korean Medicine
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    • v.27 no.2
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    • pp.85-107
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    • 2023
  • Objective : To investigate the usage of Korean herbal medicine (KHM) for climacteric symptoms, this study reviewed clinical studies conducted in Korea. Method : Literature search was performed on three Korean database; OASIS, RISS and NDSL. Studies published before July 2023 were categorized and analyzed according to the study type and herbal prescriptions. Results : Fifty-eight studies including 7 controlled trial, 27 case series and 24 single case reports were included in our review and the total number of case patients was 420. 52 prescriptions based on syndrome identifications and 11 prescriptions of Sasang constitutions were used and the most frequently used prescriptions were Soyosan(逍遙散) and Guibitang(歸脾湯). Thirty-two prescriptions were also mentioned in previous delphi research or clinical practice guideline, and the rest were not. Thirty-five studies used acupuncture combined with KHM and 10 studies used pharmacopuncture and 5 studies used herbal hipbath. Conclusion : To increase the therapeutic effect of KHM and establish KHM as an alternative to hormone treatment, various prescriptions should be used according to syndrome identifications in the clinical field. High-quality RCTs on frequently used prescriptions and the development of various type of KHM are also necessary.

The Review of Domestic Research on Traditional Korean Medicine for Gastroesophageal Reflux Disease (위식도 역류질환에 대한 한의학 연구 경향 분석: 국내 논문을 중심으로)

  • Hyun seo, Nam
    • The Journal of Korean Medicine
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    • v.44 no.2
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    • pp.70-105
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    • 2023
  • This study was conducted to examine the current status of traditional korean medicine studies on gastroesophageal reflux disease in Korea, identify deficiencies, and suggest the direction of future medicine research methods to lay the foundation for traditional korean medicine treatment. All domestic papers on the korean traditional treatment of gastroesophageal reflux disease were selected among the literature published until August 2022 in six domestic databases. A total of 52 selected research data were classified into experimental research papers, clinical research papers, and review papers. In experimental papers, to evaluate the effectiveness of treatment, improvement of esophageal mucosal lesions, anti-inflammatory mechanisms, antioxidant mechanisms, esophageal mucosal protection mechanisms, gastric peristalsis control, and gastric acid secretion inhibition mechanisms were used as evaluation measures. In the clinical research paper, the basis for diagnosis of cases was clinical symptoms through medical history listening and diagnosis through visits to hospitals in the past. The average treatment period was 40.7 days, and the duration of treatment was not significantly affected by the duration of the disease. The most widely used Korean medicine treatment intervention was herbal medicine. There were 3 literature review studies, 3 systematic literature review and meta-analysis studies, 1 comparative review study for clinical trial guideline development, all using Chinese papers. This study included all domestic papers on gastroesophageal reflux disease to identify the research trend of the Korean oriental medicine community, and based on this, it is meaningful to confirm areas that need to be supplemented in future research plans.

Clinical application of Whidam's Su-Gi therapy to Low back pain (요통에 대한 휘담식 수기요법의 임상 적용)

  • Hun Mo Ahn;Sung Jin Chang;Han Joo Kang
    • Journal of Korean Medical Ki-Gong Academy
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    • v.21 no.1
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    • pp.13-21
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    • 2022
  • Objective : This report aimed to provide an introduction to the clinical application of Whidam's Su-Gi therapy to low back pain. Methods : Whidam's Su-Gi therapy for low back pain consisted of manual therapy according to upward and downward evaluations. Upward evaluation items include SLR, hip joint LOM, legs raising together, raising knee and turning left and right, and waist raising. Downward evaluation items include spinal alignment in sitting position, shoulder part tension, and cervical part tension. After performing the manual therapy according to the evaluation at each stage, the pain and dysfunction are reevaluated to confirm the negative and proceed to the next step. Conclusions : The clinical application of Whidam's Su-Gi therapy to low back pain is a method of interpreting and approaching low back pain disease with the theory of attraction pathology according to the principle of ChoGi-therapy(調氣療法).