scholarly journals Evidence‐based insomnia treatment strategy using novel orexin antagonists: A review

2021 ◽  
Author(s):  
Taro Kishi ◽  
Maika Nishida ◽  
Michinori Koebis ◽  
Takehiro Taninaga ◽  
Kenzo Muramoto ◽  
...  
Keyword(s):  
Treatment Strategy ◽  
Evidence Based ◽  
Insomnia Treatment

Evidence-based optimal treatment strategy of patients with angina pectoris

2008 ◽  
Vol 149 (7) ◽  
pp. 293-298
Author(s):  
András Jánosi
Keyword(s):  
Angina Pectoris ◽  
Treatment Strategy ◽  
Optimal Treatment ◽  
Evidence Based ◽  
Optimal Treatment Strategy

A szerző összefoglalja a stabil angina pectoris optimális kezelésével kapcsolatos evidenciákat. Az invazív kezelési stratégia (katéterterápia) térnyerése a stabil angina pectoris esetében is megfigyelhető. Számos országban – így hazánkban is – a percutan intervenciók száma meghaladja a műtéti beavatkozások gyakoriságát. A percutan intervenció, illetve a revascularisatiós műtét helyének meghatározása az angina pectoris kezelésében igen fontos és sokszor vitatott klinikai probléma. A szerző áttekinti a lehetséges három kezelési mód (gyógyszeres kezelés, percutan intervenció, revascularisatiós műtét) eredményességét vizsgáló randomizált tanulmányokat, illetve az ezekből levonható következtetéseket. A rendelkezésre álló adatok azt igazolják, hogy – a diagnózis objektív módszerrel is alátámasztott felállítása után első lépésben – a rizikófaktorok korrekciója, az életmódrendezés és az optimális gyógyszeres kezelés a választandó kezelési stratégia. Optimális gyógyszeres kezelésnek tekintjük a statin-, aszpirin-, ACE-gátló-terápiát és a tünetek befolyásolására irányuló antianginás kezelést, amelyben a béta-blokkoló alkalmazásának elsőrendű jelentősége van. A percutan intervenció első terápiás eszközként történő alkalmazása nem indokolt, mivel nincs adat arra, hogy javítaná az életkilátásokat, illetőleg a beavatkozással megelőzhető lenne a szívinfarktus. Amennyiben a panaszok gyógyszeres kezeléssel nem vagy nem eléggé befolyásolhatók, indokolt a revascularisatio (percutan intervenció vagy műtét) elvégzése, mivel e beavatkozásokkal a gyógyszeres kezelésnél jobban javítható a funkcionális stádium. A revascularisatiós műtét bizonyos esetekben (pl. főtörzsszűkület, háromérbetegség és csökkent balkamra-funkció) a panaszok kedvező befolyásolásán túlmenően a betegek életkilátásait is javítja. A rendelkezésre álló kezelési lehetőségek optimális megválasztása nemcsak a betegek számára fontos, hanem komoly gazdasági jelentősége is van.

scholarly journals Feasibility of Screening for Frailty in Elderly Patients with Arterial Hypertension: Age Is Not a Hindrance?

Medicina ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 36-57
Author(s):  
S. N. Bel'diev ◽  
◽  
E. V. Andreeva ◽  
E. I. Berezina ◽  
I. V. Egorova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Drug Treatment ◽  
Arterial Hypertension ◽  
Treatment Strategy ◽  
Clinical Guidelines ◽  
Critical Analysis ◽  
Geriatric Care ◽  
Evidence Based ◽  
Care Availability

The Russian clinical guidelines "Arterial hypertension in adults" (2020) contain a statement according to which elderly (≥65 years) patients should be screened for frailty using "Vozrast ne pomeha" (verbatim – "Age is not a hindrance") questionnaire, since the identification of frailty can affect drug treatment strategy and level of target blood pressure. The paper presents a critical analysis of this statement, which shows that recommendation to use "Vozrast ne pomeha" questionnaire for frailty screening is insufficiently evidence based and does not fully take into account the problem of geriatric care availability.

scholarly journals Prisoners' insomnia: to treat or not to treat? Medical decision-making in places of detention

2008 ◽  
Vol 48 (4) ◽  
pp. 307-316 ◽  
Author(s):  
Bernice S. Elger
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Ethical Issues ◽  
Public Health Problem ◽  
Medical Decision ◽  
Evidence Based ◽  
Correctional Institutions ◽  
Efficient Treatment ◽  
Adequate Evaluation ◽  
Insomnia Treatment

Insomnia is a frequent reason for medical and psychiatric consultation in prisons. Medical decision-making in correctional health care should be based on the same principles as outside correctional institutions. In places of detention, principles should be balanced according to the same criteria as outside correctional institutions, while taking into account the unique harm-benefit ratios related to the specific context. The aim of this paper was to examine the existing attitudes and ethical issues related to decision-making about insomnia evaluation and treatment in places of detention. An analysis of the ethical issues and an evidence-based review of the consequences of different attitudes and treatments with regard to prison medicine were carried out. Insomnia is a public health problem and requires adequate evaluation and treatment to avoid more serious health consequences both within and outside correctional institutions. Insomnia treatment in places of detention is an ethical dilemma, but there is no evidence-based reason to avoid benzodiazepines in prison completely and to use only neuroleptics and antidepressants, which might represent more dangerous and less efficient treatment. In prison medicine, should we even treat insomnia? Widely accepted ethical strategies of decision-making indicate that we should. Institutional guidelines on insomnia should be based on ethically sound decision-making that takes into account the available evidence.

scholarly journals Diagnosis and Treatment of Femoral Head Osteonecrosis: A Protocol for Development of Evidence Based Clinical Practice Guidelines

2020 ◽  
Author(s):  
Edward Cheng ◽  
Michael A. Mont ◽  
Stuart B. Goodman ◽  
Rafael J Sierra ◽  
Quanjun Cui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Femoral Head ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Treatment Strategy ◽  
Large Scale ◽  
Patient Specific ◽  
Evidence Based ◽  
Femoral Head Osteonecrosis

Abstract Background: There are many treatment options for patients who have osteonecrosis of the femoral head (ONFH) and management strategies vary widely both among and within individual countries. Although many researchers have attempted to elucidate the optimal strategies for managing this disease, the lack of large-scale randomized control trials and the lack of agreement on disease staging have curtailed the development of clear-cut guidelines.Methods: The Association Research Circulation Osseous (ARCO) group sought to address three questions for the management of patients who have ONFH: (1) What imaging studies are most sensitive and specific for the diagnostic evaluation of patients who have ONFH?; (2)What is the best treatment strategy for preventing disease progression in patients who have pre-collapse lesions?; and (3) What is the best treatment strategy for patients who have post-collapse disease? The PICO (Patient, Intervention, Comparison, and Outcome) format was used to formulate the search strategy for each research question. A systematic review will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ARCO participants have been allocated to three groups, each representing one of the PICO questions. After qualitative and quantitative analysis of the data extracted from studies pertaining to each of the three research questions, a set of evidence-based clinical practice guidelines will be proposed for the management of patients who have ONFH. Discussion: It is not always clear which treatment method is optimal for the management of ONFH. Thus, many surgeons have developed and performed various procedures based on various patient-specific factors. As there is no consensus on the optimal treatment for various stages of disease, it was clear that developing evidence-based clinical practice guidelines would provide more structure and uniformity to management of these patients. Therefore, the results of this systematic review will lead to the development guidelines that may improve patient-care strategies and result in better outcomes for patients who have ONFH.Systematic Review Registration: Registration with PROSPERO has been submitted and is pending.

scholarly journals COVID-19 and Cardiovascular System. Part 3. COVID-19 Current Treatment Approaches: Evidence-Based Review

2021 ◽  
Vol 10 (3) ◽  
pp. 438-451
Author(s):  
M. K. Vasilchenko ◽  
A. A. Ivannikov ◽  
A. N. Yesaulenko ◽  
Kh. G. Alidzhanova ◽  
S. S. Petrikov
Keyword(s):  
Clinical Trials ◽  
Cardiovascular System ◽  
Mechanism Of Action ◽  
Treatment Strategy ◽  
Large Scale ◽  
Management Plan ◽  
Current Treatment ◽  
Evidence Based ◽  
Potential Mechanism ◽  
System Part

Unified management plan and treatment strategy for COVID-19 patients are yet to be discovered. Many trials on COVID-19 interventions have been registered or are ongoing. In this article the results of large-scale clinical trials on COVID-19 treatment are presented, the potential mechanism of action of some drugs is discussed, the features of the main pharmacological and non-pharmacological therapeutic options for COVID-19 patients are described.

An Evidence-Based Review of Insomnia Treatment in Early Recovery

2014 ◽  
Vol 8 (6) ◽  
pp. 389-394 ◽  
Author(s):  
Katherine A. Kaplan ◽  
John McQuaid ◽  
Charles Primich ◽  
Nicholas Rosenlicht
Keyword(s):  
Evidence Based ◽  
Early Recovery ◽  
Insomnia Treatment

scholarly journals Evidence based physiotherapy in gynecology

2005 ◽  
Vol 54 (3) ◽  
pp. 99-107
Author(s):  
G. N. Ponomarenko
Keyword(s):  
Treatment Strategy ◽  
Controlled Trials ◽  
Evidence Based ◽  
Physical Methods ◽  
Gynecological Diseases ◽  
Choice Of Treatment

Methodical aspects of evidence based physiotherapy application in gynecology are considered in the article. Basis of methodology and advantage of evidence based physiotherapy for the proof of medical effects, choice of treatment strategy (or preventive maintanance) in patients with gynecological diseases are presented. The actual base of controlled trials of medical physical methods have been made last years in gynecology, and the basic directions of practical use of principles of evidence based physiotherapy are presented.

Sign in / Sign up

Export Citation Format

Share Document