scholarly journals Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

2017 ◽  
Vol 62 (6) ◽  
pp. 40-77 ◽  
Author(s):  
Ivan I. Dedov ◽  
Galina A. Melnichenko ◽  
Natalia G. Mokrysheva ◽  
Liudmila Y. Rozhinskaya ◽  
Nikolay S. Kusnezov ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Manifestations ◽  
Pathological Process ◽  
Differential Diagnostics ◽  
Evidence Based ◽  
Management Concept ◽  
Set Up ◽  
International Experts ◽  
Based Medicine ◽  
Methods Of Treatment

Primary hyperparathyroidism (PHT) is the third most common endocrine disorder in men and women after diabetes mellitus and thyroid disease and one of the most frequent causes of osteoporosis and fractures among the secondary osteopathy. PHT refers to socially significant problems in connection with involvement in the pathological process of the majority of organs and system In recent years, the conception of epidemiology, clinic and tactics of management of patients with PHT has changed due to significant increase of morbidity at the expense of identification of mild forms of disease. The modern management concept tactics depends on clinical manifestations. Bearing in mind the importance of the problem under consideration, the working group was set up for the development of federal recommendations on the treatment of PHT based on the principles of evidence-based medicine. The experience accumulated by the domestic and international experts was summarized in the federal clinical guidelines on PHT.

scholarly journals Current Approaches in Management of Patients with Hypophosphatasia

2021 ◽  
Vol 17 (6) ◽  
pp. 519-528
Author(s):  
Alexander A. Baranov ◽  
Leyla S. Namazova-Baranova ◽  
Sergey I. Kutsev ◽  
Tea V. Margieva ◽  
Nato D. Vashakmadze ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Genetic Disease ◽  
Pediatric Patients ◽  
Clinical Guideline ◽  
Treatment Guidelines ◽  
Differential Diagnostics ◽  
Evidence Based ◽  
Specific Alkaline Phosphatase ◽  
Enzyme Replacement ◽  
Based Medicine

he authors present the latest data on the hypophosphatasia (HPP) management in children. Hypophosphatasia is a rare genetic disease caused by deficiency of tissue-specific alkaline phosphatase due to mutation in the ALPL gene. The article covers all the features of epidemiology, etiology and pathogenesis, detailed stages of differential diagnostics. Treatment guidelines for pediatric patients are provided, they are based on the principles of evidence-based medicine. Special attention was given to the only effective method of hypophosphatasia management —enzyme replacement therapy (ERT). This material is the clinical guideline draft for the management of patients with hypophosphatasia prepared by the Union of Pediatricians of Russia and the Association of Medical Geneticists.

scholarly journals THERAPEUTIC METHODS IN CEREBRAL PALSY FROM THE STANDPOINT OF EVIDENCE-BASED MEDICINE

2019 ◽  
Vol 21 (3) ◽  
pp. 168-174
Author(s):  
Leila A. Pak ◽  
K. V. Zherdev ◽  
L. M. Kuzenkova ◽  
A. L. Kurenkov ◽  
B. I. Bursagova
Keyword(s):  
Cerebral Palsy ◽  
Stem Cell ◽  
Evidence Based Medicine ◽  
Vagal Stimulation ◽  
Clinical Manifestations ◽  
Evidence Based ◽  
Complementary Treatment ◽  
Epidural Stimulation ◽  
Meta Analyses ◽  
Based Medicine

In the article the authors consider such methods of the alternative/complementary treatment of the cerebral palsy (CP), presented in the modern domestic and foreign literature, as metabolic (amino acid composites), metamer (I.A. Skvortsov), intravenous administration of baclofen, antiepileptic (vagal stimulation, levetiracetam), acupuncture, transcranial cerebral micropolarization, epidural stimulation, modified motion-induced restriction therapy (MMIRT), stem cell therapy, as well as some other complementary/palliative approaches to the correction of clinical manifestations of various forms of CP. The final part of the article presents the attitude of modern evidence-based medicine to the main methods of the alternative/complementary treatment of cerebral palsy. These data are based almost exclusively on international systematic reviews and relevant meta-analyses.

scholarly journals Principles of drug therapy for acute bacterial rhinosinusitis: from evidence-based medicine to practice

2018 ◽  
Vol 26 (1) ◽  
pp. 106-116
Author(s):  
D. S. Pshennikov ◽  
I. B. Angotoeva
Keyword(s):  
Evidence Based Medicine ◽  
Therapeutic Approach ◽  
Bacterial Resistance ◽  
Diagnostic Errors ◽  
High Rate ◽  
Differential Diagnostics ◽  
Evidence Based ◽  
Wide Range ◽  
Acute Bacterial Rhinosinusitis ◽  
Based Medicine

The problem of treatment of acute rhinosinusitis (ARS) is extremely important due to high prevalence of the disease. According to statistical data the ARS affects from 6% to 15% of population and does not show any tendency to reduction. These figures are associated with a high rate of acute respiratory viral infection (ARVI) which directly leads to rhinosinusitis. But, however, despite the fact that practically every individual experiences from 2 to 5 episodes of ARVI every year, only 0.5-2% of them are complicated with acute bacterial rhinosinusitis (ABRS). Despite this low percentage of bacterial infection, in 80% of cases systemic antibacterial treatment is prescribed which further worsens the problem of bacterial resistance in the world. The main difficulty in determination of therapeutic approach to ABRS is associated with absence of reliable methods of differential diagnostics of viral and bacterial etiology of the disease. Because of low sensitivity and specificity, none of additional visualization methods of ABRS diagnosing such as radiography, ultrasonography, computed tomography, can be used as a routine laboratory method. Thus, the main method of differential diagnostics of viral and bacterial ARS remains analysis of clinical data which leads to a high rate of diagnostic errors and to polypragmacy. Nowadays there exists a wide range of medications for treatment of ABRS in the pharmacological market. The choice of therapeutic approach by our international colleagues is mostly based on the requirements of evidence-based medicine. Russian scientists, besides evidence-based medicine principles take into account the pathogenesis of the disease. In this article different groups of medications for treatment of ABRS are presented. Some of them do not meet the requirements of evidence-based medicine so far, but they are included to the Russian standards and are used for management of ABRS.

Management of menopausal women with a history of endometriosis

GYNECOLOGY ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 41-44
Author(s):  
Elena I. Ermakova ◽  
Svetlana V. Yureneva
Keyword(s):  
Past History ◽  
Position Statement ◽  
Point Of View ◽  
Evidence Based ◽  
Natural Menopause ◽  
Menopausal Women ◽  
History Of ◽  
Based Medicine ◽  
Methods Of Treatment ◽  
Postmenopausal Endometriosis

Aim. To formulate a position statement on the management of the menopause in women with a past history of endometriosis from the point of view of evidence-based medicine. Materials and methods. Review of domestic and foreign literature, position of IMS and EMAS. Results. The article describes the main modes snd ways of introducing MHT and their advantages. The expert position on the management of patients with a history of endometriosis during surgical and natural menopause is highlighted. Information on the prevalence and methods of treatment of postmenopausal endometriosis is given.

Pituitary incidentalomas: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

2015 ◽  
Vol 61 (3) ◽  
pp. 57-68 ◽  
Author(s):  
I I Dedov ◽  
G A Melnichenko ◽  
L K Dzeranova ◽  
E A Pigarova ◽  
L Ya Rozhinskaya ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Signs And Symptoms ◽  
Long Term Results ◽  
Differential Diagnostics ◽  
Diagnostic Study ◽  
Wide Circle ◽  
Clinical Signs And Symptoms ◽  
Set Up ◽  
International Experts ◽  
Available Information

Incidentalomas are the most common neoplasms in the hypothalamic-pituitary region. Diagnostics, treatment strategy, and indications for the surgical intervention on the patients with these tumours pose a serious challenge for a wide circle of specialists. The diagnostic problems arise from the absence of the specific clinical signs and symptoms as well as the reliable biochemical markers of the disease. The modern laboratory methods do not allow to reveal the pathological hormonal secretion during the diagnostic study, predisposition of the neoplasm to the invasive and infiltrative growth, and signs of its «aggressiveness». This considerably complicates the choice of the optimal surgical strategy and the evaluation of the long-term results of the treatment. Bearing in mind the importance of the problem under consideration, the working group was set up for the development of federal recommendations on the treatment of pituitary incidentalomas based on the principles of evidence-based medicine. The experience accumulated by the domestic and international experts was summarized in the federal clinical guidelines on pituitary incidentalomas containing the available information about these neoplasms.

scholarly journals Subacute cough in preschool children: differential diagnostics and differentiated therapy under ambulatory practice

2021 ◽  
pp. 46-55
Author(s):  
S.A. Mokiya–Serbina ◽  
◽  
T.V. Litvinova ◽  
N.I. Zabolotnyaya ◽  
◽  
...  
Keyword(s):  
Preschool Children ◽  
Respiratory Tract ◽  
Evidence Based Medicine ◽  
Respiratory Infections ◽  
Differential Diagnostics ◽  
Evidence Based ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Outpatient Practice ◽  
Based Medicine

The multifactorial nature of subacute cough, combined with the anatomical and physiological characteristics of preschool children, the impossibility of their full examination in outpatient practice, complicates its diagnosis. An algorithm for the differential diagnosis of acute respiratory infections accompanied by subacute cough in preschool children has been developed, it can contribute to the early identification of its causes and targeted treatment of the disease that caused the cough. A sequence of diagnostic measures is proposed, it includes anamnesis of life and diseases with a list of key questions that should be asked when collecting anamnesis in children with prolonged cough; objective examination of the child; determination of the tactics of further management (inpatient or outpatient); the choice of therapy that is comparable to the intended diagnosis; and evaluation of ongoing therapy. The emphasis is made on the importance of a full-fledged collection of anamnesis, taking into account the data of the time and conditions of the disease, and clinical data for making a presumptive diagnosis in an outpatient practice. It is recommended to carry out trial therapy if the diagnosis is difficult. The article presents modern approaches to the diagnosis of bronchial asthma in children with recurrent virus-induced vising. The modern approaches to the diagnosis and treatment of acute respiratory infections of the upper and lower respiratory tract are outlined in accordance with the principles of evidence-based medicine. It is noted that the most effective methods of treating cough are etiological and pathogenetic approaches, which consist in eliminating or weakening the action of factors that cause cough. It is emphasized that if treatment is impossible or insufficient, symptomatic cough therapy should be carried out. The main directions of symptomatic treatment of cough have been substantiated, which include measures to improve the drainage function of the lungs and restore adequate mucociliary clearance. The expediency of using ambroxol and acetylcysteine preparations was confirmed. Attention is also paid to the use of centrally acting antitussives. Discussion of the problem «to treat or not to treat subacute cough in acute respiratory infection of the upper respiratory tract» from the standpoint of evidence-based medicine is shown. No conflict of interest was declared by the authors. Key words: children, subacute cough, acute respiratory infections.

scholarly journals Evidence-Based Pharmacotherapy of ADHD

2021 ◽  
Author(s):  
Irina Vladimirovna Dubatova ◽  
Andrey Viktorovich Antsyborov
Keyword(s):  
Treatment Process ◽  
Negative Impact ◽  
Mechanisms Of Action ◽  
Childhood And Adolescence ◽  
Evidence Based ◽  
Hyperactivity Disorder ◽  
Psychotherapeutic Interventions ◽  
Based Medicine ◽  
Methods Of Treatment

Attention deficit hyperactivity disorder (ADHD) is a widespread, severe neurobiological disorder that occurs in childhood and adolescence and has a negative impact on social functioning in adulthood. Currently, there are several strategies for the treatment of ADHD including pharmacotherapy and psychotherapeutic interventions. Due to the expansion of the range of available drugs, for practical doctors to choose the tactics of therapy and to set priorities in the treatment process becomes more challenging. The aim of this review is to systematize the evidence-based literature on the treatment of ADHD, based on the principles of evidence-based medicine. The review considers the main mechanisms of action of the drugs used, the role of non-drug methods of treatment, as well as drugs that are not widely used. The most relevant treatment approaches, which have been proven to be effective and safe, are discussed.

scholarly journals THE MAIN FEATURES OF EVIDENCE-BASED MEDICINE IN THE TREATMENT AND REHABILITATION OF PATIENTS IN MAXILLOFACIAL SURGERY

ASJ. ◽  
2020 ◽  
Vol 1 (43) ◽  
pp. 30-33
Author(s):  
S. Тemirbolatova ◽  
A. Shogenov
Keyword(s):  
Evidence Based Medicine ◽  
Maxillofacial Surgery ◽  
Scientific Data ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Key Skills ◽  
Assessment Of Evidence ◽  
Based Medicine ◽  
Methods Of Treatment

The paper considers the features of modern evidence-based medicine, its role and place in modern clinical practice, the role of assessing the effectiveness of drug therapy, the principles of conducting clinical trials of drugs. The results obtained will find wide application in the choice of methods of treatment and rehabilitation of patients in the Department of Maxillofacial Surgery, which will contribute to the development of this branch of medicine. Introduced modern scientific data into practice, which includes 5 key skills: study of questions and problems, with a detailed detailed answer to them, to conclude a method of treating a patient, a conservative approach or the degree of effectiveness of surgery; a detailed analysis of electronic literature of the corresponding type and level of evidence; selection of research methods and assessment of evidence of their necessity; the ability to implement the final results, and use them in the process of treating patients.

scholarly journals Evidence-based policing

2020 ◽  
Vol 62 (3) ◽  
pp. 162-185
Author(s):  
Dragana Spasić
Keyword(s):  
Police Officers ◽  
Professional Community ◽  
Decision Making Process ◽  
Evidence Based ◽  
Comprehensive Description ◽  
New Approach ◽  
Police Decision Making ◽  
Set Up ◽  
Based Medicine ◽  
Evidence Based Policing

The concept of evidence-based policing is a relatively new approach to policing that has been drawing the attention of the scientific and professional public for more than two decades, and which was inspired by a broader movement, based on the notion of "evidence-based practice". Around the world associations (so called societies) have been set up to advance the idea of evidence-based policing trough conducting and disseminating police research. The intention of the academic and professional community is to create a knowledge base that will assist the police in making decisions regarding the implementation of particular strategies and tactics in order to achieve the desired goal. Despite the current relevance of this issue, a previously conducted survey among police officers and police educators from these areas has shown that a large number of them are not yet aware of the concept mentioned above. Bearing this in mind, as well as the fact that the majority of the respondents stated that they turn to journal Bezbednost when acquiring information about the latest topics and trends in the field of policing, the author here seeks to give brief but comprehensive description of the new concept. In order to make this possible, the first part of the paper gives an overview of the notion of evidence-based medicine and the early origins of the idea of evidence-based policing. The second part of the paper is devoted to defining the notion of evidence-based policing and to more closely defining the term "evidence" in this context. Finally, a model is presented, created by Sherman, that represents the proposed framework for incorporating this concept into the police decision-making process.

Huntington’s disease

2020 ◽  
Vol 1 (3) ◽  
pp. 139-158
Author(s):  
Sergey A. Klyushnikov
Keyword(s):  
Genetic Counseling ◽  
Genetic Correlations ◽  
Clinical Manifestations ◽  
Premature Death ◽  
Mutant Gene ◽  
Symptomatic Treatment ◽  
Pathological Process ◽  
Differential Diagnostics ◽  
Disease Epidemiology ◽  
Complete Penetrance

Huntingtons disease is one of the most common hereditary neurodegenerative diseases, which remains practically incurable, inevitably leading to the disability of patients and premature death. A fairly wide prevalence in the world, the special severity of the course, the almost complete penetrance of the mutant gene, the peculiarity of clinical and genetic correlations in Huntingtons disease have attracted researchers specializing in neuroscience for many years. The study of the molecular neurobiology of Huntingtons disease over the past decades has largely contributed to significant progress in molecular biology, genetics, and many other biomedical disciplines. At the same time, Huntingtons disease has become a model disease in resolving issues of genetic counseling and prognostic testing in modern medical genetics. The review provides brief facts on the history of the study of the disease, including mapping and identification of the mutant gene. The issues of etiology and pathogenesis, molecular genetics of the disease, epidemiology, diagnostics, and differential diagnostics are discussed in detail. The spectrum of clinical manifestations of Huntingtons disease, its various forms, and course features are presented. From a modern perspective, the problem of developing valid biomarkers of both the manifest and the asymptomatic stages of the disease, as well as the course of the pathological process, are highlighted. The main issues of primary and secondary prevention of Huntingtons disease, bioethical principles of conducting genetic counseling for families burdened by this disease are outlined. The approaches to the symptomatic treatment of Huntingtons disease are described, a review of the main promising experimental therapeutic methods that can potentially slow down or stop the progression of the disease, as well as prevent its manifestation in asymptomatic carriers of the mutant gene, are presented. An important contribution of patient organizations to addressing issues affecting the interests of burdened families, scientific and clinical research on the disease was noted. Literature was searched and analyzed using the databases of Scopus, Web of Science, Pubmed (MedLine), eLibrary.

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