Objective: To evaluate the utility of the UAC as a biomarker for early CKD diagnosis in dogs and examine its correlation with other renal biomarkers in a large-scale clinical study. Methods: This study included 99 healthy dogs and 122 dogs with CKD. The UAC and other renal biomarkers were measured and evaluated in healthy dogs and those with CKD and categorized according to the staging criteria of the International Renal Interest Society (IRIS). Results: Dogs with CKD had significantly higher UACs than healthy dogs (p < 0.05). The UAC correlated with the IRIS stages and other renal biomarkers (p < 0.05). Receiver operating characteristic curve analysis yielded an area under the curve of 0.817 (p < 0.05) for the UAC, with a cut-off value of 19.20 mg/g, showing 72% sensitivity and 71% specificity. A “grey zone” diagnostic window for early-stage CKD was introduced. Conclusions and Relevance: The UAC is effective for the early diagnosis of renal disease in dogs. The UAC can differentiate between healthy dogs and those with CKD at IRIS stage 1.The diagnostic value is enhanced when used alongside other renal biomarkers, allowing for more specific guidelines for pet owners and veterinarians. This large-scale study addresses the limitations of previous research conducted on small clinical samples.

Objective: To evaluate the utility of the UAC as a biomarker for early CKD diagnosis in dogs and examine its correlation with other renal biomarkers in a large-scale clinical study. Methods: This study included 99 healthy dogs and 122 dogs with CKD. The UAC and other renal biomarkers were measured and evaluated in healthy dogs and those with CKD and categorized according to the staging criteria of the International Renal Interest Society (IRIS). Results: Dogs with CKD had significantly higher UACs than healthy dogs (p < 0.05). The UAC correlated with the IRIS stages and other renal biomarkers (p < 0.05). Receiver operating characteristic curve analysis yielded an area under the curve of 0.817 (p < 0.05) for the UAC, with a cut-off value of 19.20 mg/g, showing 72% sensitivity and 71% specificity. A “grey zone” diagnostic window for early-stage CKD was introduced. Conclusions and Relevance: The UAC is effective for the early diagnosis of renal disease in dogs. The UAC can differentiate between healthy dogs and those with CKD at IRIS stage 1.The diagnostic value is enhanced when used alongside other renal biomarkers, allowing for more specific guidelines for pet owners and veterinarians. This large-scale study addresses the limitations of previous research conducted on small clinical samples.

Objective: To evaluate the utility of the UAC as a biomarker for early CKD diagnosis in dogs and examine its correlation with other renal biomarkers in a large-scale clinical study. Methods: This study included 99 healthy dogs and 122 dogs with CKD. The UAC and other renal biomarkers were measured and evaluated in healthy dogs and those with CKD and categorized according to the staging criteria of the International Renal Interest Society (IRIS). Results: Dogs with CKD had significantly higher UACs than healthy dogs (p < 0.05). The UAC correlated with the IRIS stages and other renal biomarkers (p < 0.05). Receiver operating characteristic curve analysis yielded an area under the curve of 0.817 (p < 0.05) for the UAC, with a cut-off value of 19.20 mg/g, showing 72% sensitivity and 71% specificity. A “grey zone” diagnostic window for early-stage CKD was introduced. Conclusions and Relevance: The UAC is effective for the early diagnosis of renal disease in dogs. The UAC can differentiate between healthy dogs and those with CKD at IRIS stage 1.The diagnostic value is enhanced when used alongside other renal biomarkers, allowing for more specific guidelines for pet owners and veterinarians. This large-scale study addresses the limitations of previous research conducted on small clinical samples.

Objective: To evaluate the utility of the UAC as a biomarker for early CKD diagnosis in dogs and examine its correlation with other renal biomarkers in a large-scale clinical study. Methods: This study included 99 healthy dogs and 122 dogs with CKD. The UAC and other renal biomarkers were measured and evaluated in healthy dogs and those with CKD and categorized according to the staging criteria of the International Renal Interest Society (IRIS). Results: Dogs with CKD had significantly higher UACs than healthy dogs (p < 0.05). The UAC correlated with the IRIS stages and other renal biomarkers (p < 0.05). Receiver operating characteristic curve analysis yielded an area under the curve of 0.817 (p < 0.05) for the UAC, with a cut-off value of 19.20 mg/g, showing 72% sensitivity and 71% specificity. A “grey zone” diagnostic window for early-stage CKD was introduced. Conclusions and Relevance: The UAC is effective for the early diagnosis of renal disease in dogs. The UAC can differentiate between healthy dogs and those with CKD at IRIS stage 1.The diagnostic value is enhanced when used alongside other renal biomarkers, allowing for more specific guidelines for pet owners and veterinarians. This large-scale study addresses the limitations of previous research conducted on small clinical samples.

Objective: The Functioning Assessment Short Test (FAST) is a relatively specific test for bipolar disorders designed to assess the main functioning problems experienced by patients. This brief instrument includes 24 items assessing impairment or disability in 6 domains of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time. It has already been translated into standardized versions in several languages. The aim of this study is to measure the validity and reliability of the Korean version of FAST (K-FAST). Methods: A total of 209 bipolar disorder patients were recruited from 14 centers in Korea. K-FAST, Young Mania Rating Scale (YMRS), Bipolar Depression Rating Scale (BDRS), Global Assessment of Functioning (GAF) and the World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were administered, and psychometric analysis of the K-FAST was conducted. Results: The internal consistency (Cronbach’s alpha) of the K-FAST was 0.95. Test-retest reliability analysis showed a strong correlation between the two measures assessed at a 1-week interval (ICC = 0.97; p ＜ 0.001). The K-FAST exhibited significant correlations with GAF (r = −0.771), WHOQOL-BREF (r = −0.326), YMRS (r = 0.509) and BDRS (r = 0.598). A strong negative correlation with GAF pointed to a reasonable degree of concurrent validity. Although the exploratory factor analysis showed four factors, the confirmatory factor analysis of questionnaires had a good fit for a six factors model (CFI = 0.925; TLI = 0.912; RMSEA = 0.078). Conclusion The K-FAST has good psychometric properties, good internal consistency, and can be applicable and acceptable to the Korean context.

The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) first was published in 2002, and has been revised four times, in 2006, 2012, 2017, and 2021. In this review, we compared recommendations from the recently revised KMAP-DD 2021 to four global clinical practice guidelines (CPGs) for depression published after 2010. The recommendations from the KMAP-DD 2021 were similar to those from other CPGs, although there were some differences. The KMAP-DD 2021 reflected social culture and the healthcare system in Korea and recent evidence about pharmacotherapy for depression, as did other recently published evidence-based guidelines. Despite some intrinsic limitations as an expert consensus-based guideline, the KMAP-DD 2021 can be helpful for Korean psychiatrists making decisions in clinical settings by complementing previously published evidence-based guidelines, especially for some clinical situations lacking evidence from rigorously designed clinical trials.

Objectives: The Korean Medication Algorithm Project for Depressive Disorder 2021 (KMAP-DD 2021) was made to update new researches and data. This study focused on non-pharmacological biological treatments. Methods: Ninety-seven psychiatrists with extensive clinical experience in the non-pharmacological biological treatment of depressive disorder were primary selected and a questionnaire was sent to each of them by mail, 65 of the 97 replied. Results: Electroconvulsive therapy (ECT) was recommended as an initial strategy for major depressive disorder, severe depressive disorder with/without psychotic features with urgent suicidal risk, or a severe depressive episode with psychotic features in pregnant patients, for non-responders on pharmacotherapy for a moderate depressive episode, and as a second strategy for non-responders on antidepressant monotherapy or combination therapy combined with physical illness. For pregnant women with a severe episode of major depressive disorder, repetitive transcranial magnetic stimulation (rTMS) was preferred as a first-line strategy, and as a second strategy for non-responders on combined antipsychotic and antidepressant therapy and non-responders with comorbidity and physical illness. Complementary or novel treatment was not recommended as the first-line treatment strategy for depressive disorder, but transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS), deep brain stimulation (DBS), light therapy, and omega-3 fatty acid nutritional therapy were second-line treatment strategies. Conclusion ECT and rTMS are initial strategies in specific clinical situations. Preferences for complementary or novel treatments such as tDCS, light therapy, and omega-3 fatty acid nutritional therapy have increased gradually, but in practice, their usages are still limited.

Objectives: To revise Korean Medication Algorithm Project for Depressive Disorder 2017 (KMAPDD 2017) guidelines by revising antidepressant choices based on their safety, adverse effects, comorbid physical illnesses, and the clinical definition of treatment-resistant depression (TRD). Methods: A 33-item questionnaire comprised of six parts was developed. A 65-expert consensus (65/97, 67.0%) was obtained on pharmacological treatment strategies regarding antidepressant choice with respect to safety, adverse effects, and comorbid physical illnesses. Multiple response sets were subjected to statistical analysis. Results: The results obtained showed that first-line pharmacotherapeutic strategies based on various clinical considerations were as follows: mirtazapine (for patients with increased suicidality, Gastrointestinal discomfort, and insomnia), bupropion (for patients with orthostatic hypotension, history of a safety accident, serotonin syndrome, sedation, sexual dysfunction, and weight gain), and escitalopram (for patients with anticholinergic side effects). For patients exhibiting comorbid conditions, duloxetine was the first line pharmacotherapeutic strategy for chronic pain, escitalopram was the first-line pharmacotherapeutic strategy for diabetes, hypertension, liver disease, Parkinson’s disease, renal disease, epilepsy, and thyroid disease, and sertraline was a first-line pharmacotherapeutic strategy for arrhythmia and cardiovascular disease. Conclusion Pharmacological treatment strategy of KMAP-DD 2021 is similar to that of KMAPDD 2017. Additional study is required to determine antidepressant choices for TRD and cancer patients with depression.

Objectives: An expert consensus guideline for the treatment of depressive disorder, the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD), was first established in 2002 and updated in 2017. To provide an up-to-date treatment guideline, KMAP-DD 2021 was recently completed. This study was undertaken to provide a guideline for the treatment of depressive disorder in a selected population that included females and elderly. Methods: The survey conducted consisted of 7 questionnaires for each population, females and elderly, with depressive disorder. A total of 65 of 97 experienced psychiatrists answered the survey. Results: For the treatment of premenstrual dysphoric disorder, the selective serotonin reuptake inhibitors, venlafaxine, and desvenlafaxine were recommended as first-line therapies. For major depressive disorder (MDD) during pregnancy, antidepressant (AD) monotherapy was recommended as a first-line therapy for mild to moderate and severe depression, and combined electroconvulsive therapy and AD with atypical antipsychotics (AAP) were recommended as a first-line therapy for severe depression with psychotic features. AD plus AAP was generally recommended for post-partum depression. In elderly with depression, AD monotherapy was recommended as the treatment of choice for mild to moderate episodes, and AD monotherapy and AD plus AAP were recommended as a first-line therapy for severe depression without psychotic features. Lastly, AD plus AAP was chosen as the treatment of choice for psychotic depression. Conclusion Present study provides an updated algorithm for the treatment of females and elderly with depressive disorders. This algorithm provides a practical aid to clinicians for the treatment of females and elderly with MDD.

Objective: The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.