scholarly journals Modern Principles of Managing Children with Food Allergies

2021 ◽  
Vol 18 (3) ◽  
pp. 245-263
Author(s):  
Alexander A. Baranov ◽  
Leyla S. Namazova-Baranova ◽  
Rakhim M. Khaitov ◽  
Natalia I. Il'ina ◽  
Oksana M. Kurbacheva ◽  
...  
Keyword(s):  
Patient Management ◽  
Clinical Manifestations ◽  
Differential Treatment ◽  
Food Allergies ◽  
Evidence Based ◽  
Methodological Guideline ◽  
Treatment And Prevention ◽  
Management Tactics

The article presents modern data on the epidemiology, etiology and clinical manifestations of food allergies in children. Evidence-based approaches to diagnosis, including differential, treatment, and prevention of food allergies in children are shown. Patient management tactics and algorithms are presented in detail. The guidelines are based on all available up-to-date data on food allergies. The material is based on the methodological guideline for the management of patients with food allergies previously developed by expert specialists of the Union of Pediatricians of Russia in 2021.

Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

2016 ◽  
Author(s):  
James H. Diaz
Keyword(s):  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Clinical Manifestations ◽  
The United States ◽  
Evidence Based ◽  
Pain Medicine ◽  
High Prevalence ◽  
Antiviral Medications ◽  
Physician’S Perspective

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. This review contains 6 figures, 4 tables and 13 references Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

New perspectives on propofol allergy

2021 ◽  
Author(s):  
Jessica L Johnson ◽  
Ashley Hawthorne ◽  
Michael Bounds ◽  
David J Weldon
Keyword(s):  
Alternative Therapy ◽  
Clinical Trial Data ◽  
Cross Reactivity ◽  
Food Allergies ◽  
Critical Examination ◽  
Evidence Based ◽  
Allergic Reactions ◽  
Definitive Evidence ◽  
Medication Costs ◽  
History Of

Abstract Purpose Propofol is an intravenous sedative used in many patient populations and care settings. Although generally considered safe and effective, the drug has historically been avoided in patients with reported allergies to egg, soy, and/or peanut on the basis of the manufacturer’s prescribing information. Concerns exist for potential adverse events, increased medication costs, reduced efficacy, and risk of medication errors when using alternative agents. Here we present a critical examination of the literature concerning cross-reactivity of food allergies with propofol to provide evidence-based recommendations for the evaluation and management of potential allergic reactions. Summary Literature regarding the history of propofol allergy warnings and clinical trial data were assessed to provide an alternative perspective on avoidance of propofol in patients with food allergies. Suspected trigger molecules are discussed with evaluation of the antigenic potential of excipient ingredients used in the manufacture of multiple propofol formulations. Evidence-based recommendations are provided for pharmacist-led screening of adult patients with reported food allergies to support selection of propofol or alternative therapy. Conclusion There is a lack of definitive evidence that propofol must be routinely avoided in patients with reported allergies to egg, soy, and/or peanut products. Data from clinical trials suggest that propofol is safe for patients with nonanaphylactic food allergies. Patients who do experience allergic reactions following administration of propofol should undergo further testing to definitively identify the specific trigger and prevent future unnecessary avoidance of preferred medication regimens. Pharmacists can play an important role in interviewing patients with reported food allergies to better determine the risk vs benefit of propofol avoidance.

Clinical epidemiology in complementary medicine (discussion)

2021 ◽  
pp. 465-474
Author(s):  
Yuriy Olegovich Novikov ◽  
Mikhail Borisovich Tsykunov ◽  
Ayrat Rafikovich Shayakhmetov
Keyword(s):  
Complementary Medicine ◽  
Clinical Epidemiology ◽  
Response To Treatment ◽  
Evidence Based ◽  
New Paradigm ◽  
Treatment And Prevention ◽  
Healthcare It ◽  
Analytical Review ◽  
Based Medicine ◽  
The Impact

The article presents an analytical review of the literature on the application of the principles of evidence-based medicine in modern healthcare. It is noted that in some areas of medicine, scientifically based standards of treatment significantly fall behind the general trends. Complementary medicine, including osteopathy, is an important healthcare resource, the use of which is officially recognized in 94 countries around the world. However, despite certain achievements in the treatment and prevention of many chronic diseases, there are scientific articles that criticize its effectiveness. Therefore, the relevance of obtaining new, strictly evidence-based data on the impact of osteopathy on health is beyond doubt. For osteopathy, as for other types of complementary medicine, a new paradigm of evidence-based clinical research is probably needed. Three types of the organism response to treatment — instant, fast and delayed — are identified.

scholarly journals Drug-Induced Heart Failure (Part 2: Mechanisms of Development, Clinical Signs, Differential Diagnosis, Risk Factors, Treatment and Prevention)

2020 ◽  
Vol 8 (2) ◽  
pp. 57-65
Author(s):  
O. D. Ostroumova ◽  
I. V. Goloborodova
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Channel Blockers ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Developing Heart

Heart failure is a complex clinical syndrome caused by an impaired pumping function of the heart muscle, etiologically associated with cardiovascular disease and, in the vast majority of cases, requiring complex therapeutic regimens and simultaneous prescription of several drugs. To date, we know several classes of drugs (including those used for heart failure) which can induce development/progression of heart failure in both patients with left ventricular dysfunction, and in patients who do not have cardiovascular diseases. The aim of the study was to analyse and systematize data on development mechanisms, as well as methods of prevention and treatment of drug-induced heart failure when using diff erent groups of drugs. It has been established that drug-induced heart failure is most often associated with the use of calcium channel blockers (verapamil, diltiazem, nifedipine), beta-blockers, antiarrhythmic drugs (disopyramide, fl ecainide, propafenone, amiodarone, ibutilide, dofetilide, dronedarone), anthracyclines (doxorubicin) and other antitumor drugs (trastuzumab, bevacizumab, infl iximab), hypoglycemic drugs (thiazolidinediones, saxagliptin, alogliptin), and nonsteroidal anti-infl ammatory drugs, including selective cyclooxygenase-2 inhibitors. The study revealed various mechanisms of heart failure development following drug treatment. In some patients, heart failure development is associated with the cardiotoxic eff ect of a particular drug, in others with adverse eff ects on hemodynamics. Much depends on risks of developing heart failure, including specifi c risks attributable to groups of drugs and individual drugs. The identifi cation of drugs that can contribute to the development/ progression of heart failure, and possible clinical manifestations of drug-induced heart failure, as well as provision of timely information to physicians, and engagement of clinical pharmacologists with the aim of optimizing treatment of patients can facilitate timely diagnosis, treatment and prevention of drug-induced heart failure. 

scholarly journals PREVALENCE AND POSSIBLE RISK FACTORS OF HEMORRHOIDAL THROMBOSIS IN PREGNANCY AND POSTPARTUM PERIOD

2019 ◽  
Vol 6 (4) ◽  
pp. 209-214
Author(s):  
Yuliya S. Medkova ◽  
D. R Markar’yan ◽  
I. A Tulina ◽  
Yu. A Churina ◽  
L. S Aleksandrov ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Postpartum Period ◽  
Patient Management ◽  
Current Data ◽  
Sufficient Evidence ◽  
Evidence Based ◽  
Initial Visit ◽  
Pregnancy And Postpartum ◽  
In Pregnancy

Introduction. Nowadays there are no sufficient evidence based data for a scientifically approach to the treatment of hemorrhoids during pregnancy and after childbirth, as well as current data of the prevalence of hemorrhoidal thrombosis (HT) and possible risk factors. Material and methods. The study included pregnant women and puerperas who were actively diagnosed with chronic hemorrhoids (CH) and HT. The physical examination was performed four times: at the woman’s initial visit to the obstetrician-gynecologist, at 24 weeks of pregnancy, at 36 weeks of pregnancy, in the postpartum period (within 7 days after delivery). Patients suffering from HT were asked to answer a questionnaire to determine possible risk factors. Results. A study was conducted on a population of 668 women. 104 women was diagnosed with CH in the postpartum period, and 81 - during pregnancy. The median VAS score with HT was 7. Second delivery, age over 30 years old, lack of physical activity during pregnancy and vaginal delivery are possible risk factors for the development of HT. Conclusions. In the presence of a high risk of HT during pregnancy and in the postpartum period, preventive examinations by a coloproctologist are an important aspect of patient management.

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 Experience in treatment and prevention of respiratory diseases relapses in children with the use of the phytotherapeutic complex «Alpicol»: feedback of doctors in Ukraine

2021 ◽  
pp. 12-22
Author(s):  
О.К. Koloskova ◽  
◽  
A.L. Kosakovskyi ◽  
T.M. Bilous ◽  
I.B. Horbatiuk ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Therapeutic Efficacy ◽  
Respiratory Diseases ◽  
Conflicts Of Interest ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Herbal Medicines ◽  
Upper Respiratory Tract ◽  
Treatment And Prevention ◽  
Parents And Children

Infectious and inflammatory diseases of the respiratory tract in children are the «leaders» among all pathologies of childhood. Optimization of therapeutic and prophylactic approaches for infectious and inflammatory pathologies of the respiratory system by reducing the frequency of unreasonable antibiotic therapy and eliminating polypragmatic use is a relevant problem of modern pediatrics and otolaryngology. According to WHO guidelines, modern standardized herbal medicines are not inferior in efficiency to synthetic ones. The aim — to analyze the results of assessment by doctors of the preventive and therapeutic efficacy of the remedy «Alpicol» on the basis of a questionnaire, as well as clinical examination of patients before using the medication and after completion of the course of treatment. Materials and methods. The advantages of «Alpicol» were analyzed through a questionnaire offered by first contact practitioners to children in order to receive feedback on the assessment of the preventive and therapeutic efficacy of this medication. Doctors from 9 regions of Ukraine were involved, and 6,093 questionnaires of children of different ages were analyzed. Results. The frequency of registration of a pronounced paediatric pain (3 scores) with the use of the «Alpicol» medication significantly decreased (23.7 times), a moderate manifestation of the disease (2 scores), was 17 times less at the same time, mild manifestations of paediatric pain remained at the same level. Patients with a comorbid pathology of the respiratory tract in the form of recurrent lesions of the upper and lower airways during the 2nd visit received a zero score (no symptoms) significantly less frequently than children with pathology of the upper respiratory tract with 62.6% of cases versus 72.2% of observations, respectively (p<0.05). As a result of the use of the course of «Alpicol» medication, a statistically significant decrease in the severity of the catarrhal symptom complex was achieved, since the proportion of the course of disease, assessed by the maximum number of scores, decreased by 29.6 times, moderate (score 2) — 13.3 times, and zero scores appeared 5.7 times more often. At the same time, the proportion of patients with a mild course of catarrh practically did not change. Conclusions. «Alpicol» has a multi;vector efficacy against the complex of symptoms that accompany infectious and inflammatory exacerbations of recurrent respiratory diseases. This is manifested by a decrease in the severity of clinical manifestations of the disease, as well as in an increase in cases of clinical stabilization of the patient's condition, which demonstrates the therapeutic and prophylactic effect of the drug «Alpicol» on the course of recurrent respiratory diseases in children. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was adopted by the Local Ethics Committee of all institutions indicated in this research. The informed consent of parents and children was obtained. The authors declare that they have no conflicts of interest. Key words: ecurrent respiratory diseases, treatment and prevention, children, phytocomplexes.

scholarly journals The role of the new coronavirus infection (COVID-19) in the progression and development of cerebrovascular diseases. A competent choice of pathogenic treatment is the key to success in treatment and prevention. An expert’s view from the ‘red zone’

2021 ◽  
Vol 13 (1) ◽  
pp. 57-66
Author(s):  
V. V. Kovalchuk
Keyword(s):  
Emotional Disorders ◽  
Clinical Manifestations ◽  
Cerebrovascular Diseases ◽  
Recent Experience ◽  
Treatment And Prevention ◽  
State Recovery ◽  
Group 2 ◽  
State Examination ◽  
Group 1

COVID-19 worsens the course of cerebrovascular diseases (CVD), including chronic cerebral ischaemia (CCI). The Actovegin drug, which has long been widely used in CCI treatment, has an antioxidant and endothelium protective effect. It makes sense to study the effect of Actovegin therapy on the clinical manifestations of CCI in patients with a recent experience of COVID-19.Objective: to evaluate Actovegin efficacy in the treatment of CCI in patients with a recent experience of COVID-19.Patients and methods. The study included 440 patients (234 female; 206 male) with a recent experience of COVID-19, suffering from CCI, their average age being 67.8 years (from 54 to 85 years). All patients were broken down into two groups of 220 people (the patients in Group 1 were administrated Actovegin, the ones in Group 2 – were not). All patients were followed up for 90 days; their condition was assessed by the severity of clinical manifestations of CCI, using special scales and questionnaires.Results and discussion. After 90 days of follow-up, the frequency of complaints of cognitive impairment, sleep disorder, dizziness, fatigue, emotional disorders, and headache in Group 1 was significantly lower than in Group 2 (p<0.05). According to Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory (MFI-20), and Spiegel Sleep Questionnaire (SSQ), the average indicators improved significantly more in Group 1 than in Group 2 (p<0.05). The absence of quality of life impairment and their minimal severity were observed in Group 1 in 77.9%; in Group 2 – in 33.7% (p<0.001). Statistically significant differences between the groups of patients were also observed in relation to emotional state recovery according to the Wakefield Questionnaire and the Spielberger State Trait Anxiety inventory.Conclusion. The observational study demonstrated the efficacy of Actovegin in the treatment of main clinical manifestations of CCI in patients with recent COVID-19 experience.

scholarly journals The analysis of complex influence of the adverse ecological/ professional factors on reproduction health of the women

2003 ◽  
Vol 52 (2) ◽  
pp. 35-46
Author(s):  
Vitaly F. Bezhenar ◽  
Evgeny F. Kira ◽  
Yuri V. Tsvelev ◽  
А. E. Antushevich ◽  
А. M. Nikiforov
Keyword(s):  
Reproductive Health ◽  
Clinical Manifestations ◽  
Toxic Chemical ◽  
Radiation Accident ◽  
Chemical Production ◽  
Occupational Factors ◽  
Treatment And Prevention ◽  
Comprehensive Examination ◽  
Health Disorders ◽  
Complex Influence

As a result of the study and generalization of the results of a comprehensive examination of 3339 women, the main mechanisms of occurrence, clinical manifestations and dynamics of reproductive health disorders in women under the combined influence of unfavorable environmental and occupational factors (radiation accident, toxic chemical production) were established and the main directions for their diagnosis, treatment and prevention were substantiated.

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