scholarly journals Natural substances and Alzheimer's disease: From preclinical studies to evidence based medicine

2012 ◽  
Vol 1822 (5) ◽  
pp. 616-624 ◽  
Author(s):  
Cesare Mancuso ◽  
Raffaella Siciliano ◽  
Eugenio Barone ◽  
Paolo Preziosi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Preclinical Studies ◽  
Natural Substances ◽  
Based Medicine

scholarly journals Nootropic drugs for correction of cognitive functions through the focus of evidence-based medicine (literature review)

2021 ◽  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Literature Review ◽  
Cognitive Functions ◽  
Evidence Based Medicine ◽  
Randomized Trials ◽  
Evidence Based ◽  
Nootropic Drugs ◽  
High Quality ◽  
Based Medicine

Relevance. In today's world, the first cause of death is pathology of the cardiovascular system. Vascular disease is influenced by many factors: lack of sleep, physical inertia, poorly balanced diet, obesity, heart disease. The fast pace of life forces a person to be in permanent stress, so as not to miss anything and have time for all the goals. This is why there is a demand for excipients and substances that could improve the peak of human cognitive abilities, maintain psychological stability. Today, the pharmaceutical market offers drugs that, according to pharmaceutical marketers, have solutions to the problems outlined above. These substances are classified to group of nootropic drugs (racetams). Objective. Review of high quality research on the effectiveness of nootropic drugs. Materials and methods. The literature review was performed using such scientometric databases as: PubMed, Cochrane Library, Scopus, BMJ Evidence-Based Medicine, Ingecta, Web of Science, UpToDate. The review included studies of randomized trials, placebo-controlled randomized trials, meta-analyzes, and systematic reviews. Data meet criteria A and B of evidence-based medicine. In the absence of high quality studies, studies with a lower level of evidence were selected. The search was made by topics: improving of cognitive functions, improving ability to work, improving sleep, improving mood, treatment of mental and psychiatric pathologies (Alzheimer's disease, dementia with various etiologies, depression), application in pediatrics. Results. The literature review included more than 40 high quality studies, but no conclusive evidence was found on the effectiveness of any drug. Conclusions. Data on the undeniable efficacy in relation to the cognitive functions of any of these nootropic drugs were not found in any study. In the treatment of Alzheimer's disease, some (Cerebrolysin, Nicergoline) drugs show controversial results of efficacy and safety. They require continued clinical research and they need to be approved by the FDA.

Are we really tackling the "evidence-based medicine issue" in Alzheimer's disease?

2016 ◽  
Vol 35 ◽  
pp. e29-e30 ◽  
Author(s):  
Marco Canevelli ◽  
Giuseppe Bruno ◽  
Nicola Vanacore ◽  
Carlo de Lena ◽  
Matteo Cesari
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine

Overtreating Alzheimer’s Disease

2020 ◽  
pp. 1-3
Author(s):  
M. Canevelli ◽  
N. Vanacore ◽  
A. Blasimme ◽  
G. Bruno ◽  
M. Cesari
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Older Persons ◽  
Social Issues ◽  
Real Life ◽  
Clinical Manifestations ◽  
Evidence Based ◽  
Biological Complexity ◽  
Beneficial Effects ◽  
Based Medicine

The management of frailty in older persons is not easy, implying interventions beyond the simple prescription of medications. Biological complexity, multimorbidity, polypharmacy, and social issues often hamper the possibility to directly translate the evidence coming from research into clinical practice. Frailty indeed represents the most relevant cause of the “evidence-based medicine issue” influencing clinical decisions in geriatric care. Today, patients with Alzheimer’s disease (AD) are much older and frailer than some decades ago. They also tend to have more drugs prescribed. In parallel, research on AD has evolved over the years, hypothesizing that anticipating the interventions to the earliest stages of the disease may provide beneficial effects (to date, still lacking). In this article, we argue that, by focusing exclusively on “the disease” and pushing to anticipate its detection (sometimes even before the appareance of its clinical manifestations) may overshadow the person’s values and priorities. Research should be developed for better integrating the concept of aging and frailty in the design of clinical trials in order to provide results that can be implemented in real life. On the other hand, clinicians should be less prone to the easy (but unsupported by evidence) pharmacological prescription.

scholarly journals Evidence-Based Research in Complementary and Alternative Medicine III: Treatment of Patients with Alzheimer's Disease

2006 ◽  
Vol 3 (4) ◽  
pp. 411-424 ◽  
Author(s):  
Francesco Chiappelli ◽  
Audrey M. Navarro ◽  
David R. Moradi ◽  
Ercolano Manfrini ◽  
Paolo Prolo
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Clinical Decision Making ◽  
Methodological Approach ◽  
Clinical Decision ◽  
Evidence Based ◽  
Based Medicine ◽  
Complementary And Alternative

This paper presents the novel domain of evidence-based research (EBR) in the treatment of patients with Alzheimer's disease (AD) from the perspective of traditional medicine and of complementary and alternative medicine. In earlier lectures we have described the process of evidence-based medicine as a methodological approach to clinical practice that is directed to aid clinical decision-making. Here, we present a practical example of this approach with respect to traditional pharmacological interventions and to complementary and alternative treatments for patients with AD.

Cholangiokarzinome

Praxis ◽  
2002 ◽  
Vol 91 (34) ◽  
pp. 1352-1356
Author(s):  
Harder ◽  
Blum
Keyword(s):  
Supportive Care ◽  
Evidence Based Medicine ◽  
Best Supportive Care ◽  
Evidence Based ◽  
Systemische Chemotherapie ◽  
Chirurgische Resektion ◽  
Multimodale Therapiekonzepte ◽  
Based Medicine

Cholangiokarzinome oder cholangiozelluläre Karzinome (CCC) sind seltene Tumoren des biliären Systems mit einer Inzidenz von 2–4/100000 pro Jahr. Zu ihnen zählen die perihilären Gallengangskarzinome (Klatskin-Tumore), mit ca. 60% das häufigste CCC, die peripheren (intrahepatischen) Cholangiokarzinome, das Gallenblasenkarzinom, die Karzinome der extrahepatischen Gallengänge und das periampulläre Karzinom. Zum Zeitpunkt der Diagnose ist nur bei etwa 20% eine chirurgische Resektion als einzige kurative Therapieoption möglich. Die Lebertransplantation ist wegen der hohen Rezidivrate derzeit nicht indiziert. Die Prognose von nicht resektablen Cholangiokarzinomen ist mit einer mittleren Überlebenszeit von sechs bis acht Monaten schlecht. Eine wirksame Therapie zur Verlängerung der Überlebenszeit existiert aktuell nicht. Die wichtigste Massnahme im Rahmen der «best supportive care» ist die Beseitigung der Cholestase (endoskopisch, perkutan oder chirurgisch), um einer Cholangitis oder Cholangiosepsis vorzubeugen. Durch eine systemische Chemotherapie lassen sich Ansprechraten von ca. 20% erreichen. 5-FU und Gemcitabine sind die derzeit am häufigsten eingesetzten Substanzen, die mit einer perkutanen oder endoluminalen Bestrahlung kombiniert werden können. Multimodale Therapiekonzepte können im Einzellfall erfolgreich sein, müssen jedoch erst in Evidence-Based-Medicine-gerechten Studien evaluiert werden, bevor Therapieempfehlungen für die Praxis formuliert werden können.

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