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2 "Practice guideline"
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Proposal to Revise the Screening Test for Latent Tuberculosis Infection in Close Contacts at Elementary Schools in Korea
Jong-Myon Bae
J Prev Med Public Health. 2019;52(4):272-275.   Published online May 8, 2019
DOI: https://doi.org/10.3961/jpmph.19.043
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AbstractAbstract AbstractSummary PDFSupplementary Material
The 2018 National Guideline for Tuberculosis Control, which was published by the Korea Centers for Diseases Prevention and Control (KCDC), mandates conducting an epidemiological survey among close contacts of active tuberculosis patients at public institutions such as schools. In the procedure for these surveys, the tuberculin skin test (TST) is mandated as the screening test for latent tuberculosis infection in elementary school students. However, several guidelines recommend using the interferon-gamma releasing assay (IGRA) for contacts aged over 5 years with a Bacillus Calmette–Guérin vaccination history. The main reason for this is that IGRA has a higher specificity and lower false positive rate than TST. In addition, IGRA requires only a single visit to draw blood and the results are available within 24 hours. These advantages could promote cooperation from both parents and students in conducting these surveys. Thus, these findings regarding the benefits of IGRA for surveys of close contacts at elementary schools should be incorporated into the KCDC guideline.
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Korean summary
집단시설에서의 결핵환자 발생시 수행하는 역학조사 지침에는 잠복결핵감염자의 검진을 위해 초등학생에게 투베르쿨린 피부반응검사 (TST)를 시행하도록 되어 있다. 그러나, 6세 이상의 초등학생들은 필수적으로 BCG 예방접종을 받았다는 점과, 역학조사 수행의 협조 등을 고려할 때 TST 대신 인터페론감마 분비검사 (Interferon-gamma releasing assay, IGRA)를 우선 시행하는 것이 보다 더 근거중심적, 가치중심적 으로 타당하다.
Original Article
Meta-analysis of the Korean Literatures for Developing Clinical Practice Guidelines of Benign Prostatic hyperplasia.
Seung Hum Yu, Chun Bae Kim, Myung Geun Kang, Jae Mann Song
Korean J Prev Med. 1997;30(3):643-664.
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This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing or pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.
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JPMPH : Journal of Preventive Medicine and Public Health