scholarly journals Managing Children with Bronchopulmonary Dysplasia

2016 ◽  
Vol 13 (4) ◽  
pp. 319-333 ◽  
Author(s):  
A. A. Baranov ◽  
L. S. Namazova-Baranova ◽  
N. N. Volodin ◽  
I. V. Davydova ◽  
D. U. Ovsyannikov ◽  
...  
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Respiratory Diseases ◽  
Professional Associations ◽  
Evidence Based ◽  
Perinatal Medicine ◽  
Chronic Respiratory Diseases ◽  
Disease Outcomes ◽  
Level Of Knowledge ◽  
Based Medicine ◽  
Russian Association

Bronchopulmonary dysplasia is one of the most significant early childhood chronic respiratory diseases. The article features modern approaches to preventing, diagnosing and treating broncho-pulmonary dysplasia, as well as ways of preventing complications and undesirable disease outcomes in patients older than 3 years. Members of professional associations — Union of Pediatricians of Russia and Russian Association of Perinatal Medicine Specialists — have summarized the experience of managing this category of patients at leading Russian pediatric centers according to the principles of evidence-based medicine and have provided scientific and practical data corresponding to the world level of knowledge with regard to the present problem.

scholarly journals Confounding in Observational Studies Explained

2012 ◽  
Vol 5 (1) ◽  
pp. 18-20 ◽  
Author(s):  
Bikaramjit Mann ◽  
Evan Wood
Keyword(s):  
Randomized Controlled Trial ◽  
Health Information ◽  
Observational Studies ◽  
Controlled Trial ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Disease Outcomes ◽  
Different Types ◽  
Based Medicine ◽  
The Impact

Practical and ethical constraints mean that many clinical and/or epidemiological questions cannot be answered through the implementation of a randomized controlled trial. Under these circumstances, observational studies are often required to assess relationships between certain exposures and disease outcomes. Unfortunately, observational studies are notoriously vulnerable to the effect of different types of “confounding,” a concept that is often a source of confusion among trainees, clinicians and users of health information. This article discusses the concept of confounding by way of examples and offers a simple guide for assessing the impact of is effects for learners of evidence-based medicine.

Evidence-Based Medicine for Respiratory Diseases

2020 ◽  
pp. 623-632
Author(s):  
Carlos Ubilla Pérez ◽  
María Angélica Palomino Montenegro ◽  
José Antonio Castro-Rodríguez
Keyword(s):  
Evidence Based Medicine ◽  
Respiratory Diseases ◽  
Evidence Based ◽  
Based Medicine

scholarly journals Focused Evidence-Based Medicine Curriculum for Trainees in Neonatal-Perinatal Medicine

MedEdPORTAL ◽  
2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohan Pammi ◽  
Krithika Lingappan ◽  
Melissa M. Carbajal ◽  
Gautham K. Suresh
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based ◽  
Perinatal Medicine ◽  
Based Medicine

The Principles and Practice of Evidence-Based Neonatology

PEDIATRICS ◽  
1999 ◽  
Vol 103 (Supplement_E1) ◽  
pp. 215-224 ◽  
Author(s):  
Roger F. Soll ◽  
Lisa Andruscavage
Keyword(s):  
Evidence Based Medicine ◽  
Newborn Infants ◽  
Evidence Based ◽  
Antenatal Corticosteroids ◽  
Perinatal Medicine ◽  
Societal Factors ◽  
Treatment And Prevention ◽  
Surfactant Replacement Therapy ◽  
Changing Practices ◽  
Based Medicine

Significant strides toward improving the outcome of newborn infants have been observed during the modern era of neonatal-perinatal medicine. One of the challenges that neonatologists and pediatricians face is deciding when to change current practices. New literature is abundant, but it must be critically reviewed and evaluated before changes in practice are made. The evidence-based medicine process can be used to help in changing practices or adopting new practices. It is based on five steps: 1) forming answerable questions; 2) searching for the best evidence; 3) critically appraising the evidence; 4) applying the evidence in practice; and 5) evaluating one's performance. This article reviews the five steps of the evidence-based medicine process. The various levels of evidence, including randomized, controlled trials and systematic reviews, are defined and discussed. An example of a critically appraised topic, a practical tool that can be used as an aid in addressing the first three questions of the evidence-based medicine process, is included. Once the evidence has been evaluated, the decision of whether or not to implement a change in individual practice or in institutional guidelines must be made. These decisions are difficult and require a variety of individual and societal factors to be taken into account. Examples of evidence-based medicine in neonatal and perinatal medicine include the use of antenatal corticosteroids for promotion of lung maturity, the use of surfactant replacement therapy for the treatment and prevention of respiratory distress syndrome, and prophylactic indomethacin for the prevention of intraventricular hemorrhage. Review of these examples provides insight into the strengths and weaknesses of evidence-based medicine.

scholarly journals Summary of the draft federal clinical guidelines for osteoporosis

2021 ◽  
Vol 23 (2) ◽  
pp. 4-21
Author(s):  
Zhanna E. Belaya ◽  
Lyudmila Y. Rozhinskaya ◽  
Tatiana A. Grebennikova ◽  
John A. Kanis ◽  
Ekaterina A. Pigarova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Combination Therapy ◽  
Clinical Guidelines ◽  
Metabolic Diseases ◽  
Evidence Based ◽  
Primary Osteoporosis ◽  
Clinical Recommendations ◽  
Modern Methods ◽  
Based Medicine ◽  
Russian Association

A summary of the draft federal clinical guidelines on osteoporosis developed by members of the Russian Association of  Endocrinologists, the Russian Association for Osteoporosis, the Association of Rheumatologists of Russia, the Association of Traumatologists and Orthopedists of Russia, the Russian Association for Menopause and the Russian Association of Gerontologists and Geriatrics is presented. The recommendations were developed from the perspective of evidence-based medicine, in accordance with the requirements for compiling clinical recommendations of the Ministry of Health of Russia published in 2019. A significant place is given to screening of primary osteoporosis in adults, differential diagnosis with other metabolic diseases of the skeleton, modern methods of diagnosing osteoporosis, principles of prescribing pathogenetic treatment, features of sequential and combination therapy, disease prevention and rehabilitation. Clinical recommendations will be useful both to general practitioners and physicians, as well as to narrow specialists, primarily endocrinologists, rheumatologists, orthopedic traumatologists, nephrologists, obstetrician-gynecologists and neurologists, since osteoporosis is a multifactorial and multidisciplinary disease.

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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