scholarly journals Risk communication: ethics, psychology, law

2021 ◽  
Vol 26 (9) ◽  
pp. 4678
Author(s):  
E. O. Taratukhin
Keyword(s):  
Risk Communication ◽  
Cultural Practice ◽  
Point Of View ◽  
Evidence Based ◽  
Psychological Perspective ◽  
State Health ◽  
Holistic View ◽  
Cultural Phenomenon ◽  
Based Medicine ◽  
Clinical Interactions

When communicating with a patient, a doctor is within a certain cultural practice (science-based medicine and state health care system), falling outside the limits of which is not legal. However, a broader understanding of medicine as a cultural phenomenon with a focus on health also requires a more varied perspective on patient care. The patient’s problem can be more complex than looking at it from science- and evidence-based point of view. Therefore, in risk communication as an element of work with adherence or as part of signing informed consent, different ways are needed to consider a patient’s situation. An ethical and psychological perspective on clinical interactions allows for a more holistic view of the disease.

scholarly journals Rehabilitation in acute stroke from the point of view of evidence-based medicine: possibilities of drug treatment

2019 ◽  
Vol 11 (3) ◽  
pp. 99-103
Author(s):  
A. A. Kulesh
Keyword(s):  
Ischemic Stroke ◽  
Drug Treatment ◽  
Acute Stroke ◽  
Evidence Based Medicine ◽  
Point Of View ◽  
Spatial Neglect ◽  
Evidence Based ◽  
Mirror Therapy ◽  
Upper Extremity Function ◽  
Based Medicine

The review highlights the fundamental principles of early rehabilitation in ischemic stroke, the benefits and risks of early and very early patient mobilization. It presents data on the efficiency of CIMT-kinesiotherapy and mirror therapy in restoring upper extremity function, as well as procedures for nonpharmacological correction of spatial neglect syndrome. The effect on the rehabilitation of concomitant Alzheimer's disease is analyzed. The areas of pharmacological potentiation of poststroke rehabilitation, the efficiency of cerebrolysin in particular, are considered.

scholarly journals Uncomfortable treatment without diagnosis

2021 ◽  
Vol LIII (1) ◽  
pp. 69-70
Author(s):  
Nikita A. Zorin
Keyword(s):  
Evidence Based Medicine ◽  
Clinical Epidemiology ◽  
Natural Process ◽  
Diagnosis And Treatment ◽  
Evidence Based ◽  
Holistic View ◽  
Theory Of Evidence ◽  
Based Medicine

One explanation for breakdown of the traditional medical connection of diagnosis and treatment is presented. It is suggested that it was a natural process brought to life by the results of the development of genetics and the results of the application of clinical epidemiology (the theory of evidence-based medicine), which led to the beginning of the downfall of the nosological concept, so far de facto, and in the long term de jure. Medicine is painfully returning to a holistic view of a patient.

scholarly journals Over-diagnosis and other crises facing evidence-based medicine

2014 ◽  
Vol 13 (3) ◽  
pp. 129-130
Author(s):  
Huw Llewelyn ◽  
Keyword(s):  
Evidence Based Medicine ◽  
Point Of View ◽  
Evidence Based ◽  
Raw Data ◽  
Acute Medicine ◽  
Coagulation Monitoring ◽  
Negative Results ◽  
Reduced Frequency ◽  
Low Threshold ◽  
Based Medicine

There is a crisis in ‘evidence-based medicine’ (EBM). Reviewers and meta-analysts have become aware that much of their work may be futile because some investigators only publish selected results that favour their own point of view. Such reviews can only be reliable if there is access to all the raw data or if everyone is compelled to publish ‘negative’ results too. This is proving difficult and controversial. The latest example is dabigatran, which was hailed as a safe advance that needs no coagulation monitoring. It seems that the reduced frequency of bleeding if there is coagulation monitoring was not reported. There is also widespread uncertainty about the thresholds for treatment. This has been highlighted in the ‘over-diagnosis campaign’ to address a concern that many patients are subjected to harm without much benefit. Many see the problem as one of vested interest e.g. where those who gain from supplying a treatment will tend to advocate a low threshold for treating whereas those who wish to reduce costs or effort prefer to set high thresholds. The evidence needs to support what is best for the patient and gathered by those who care for them e.g. acute medicine physicians.

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.

scholarly journals Treating psychiatric symptoms and disorders with non-psychotropic medications

2019 ◽  
Vol 21 (2) ◽  
pp. 193-201
Keyword(s):  
Internal Medicine ◽  
Psychotropic Drugs ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Disorders ◽  
Psychotropic Medications ◽  
Point Of View ◽  
Evidence Based ◽  
Sufficient Data ◽  
Level Of Evidence ◽  
Based Medicine

A few drugs prescribed in internal medicine, ie, non-psychotropic drugs, can be used to treat certain neuropsychiatric disorders. For most of these situations, the level of evidence remains low. But when sufficient data becomes available, these molecules are then included in official guidelines for the treatment of neuropsychiatric disorders. In this article we review interesting drugs which may be relevant from an evidence-based medicine point of view, and could become part of psychiatric practice in the future.

scholarly journals Anti-D-immunoprophylaxis

2015 ◽  
Vol 64 (3) ◽  
pp. 52-57
Author(s):  
Nataliya Grigor’yevna Pavlova
Keyword(s):  
Evidence Based Medicine ◽  
Point Of View ◽  
European Countries ◽  
Evidence Based ◽  
Federal Programs ◽  
Foreign Countries ◽  
Economic Advisability ◽  
Based Medicine ◽  
Working Out

The working out and introducing of anti-D-immunoprofylaxis program in the time of pregnancy in foreign countries and Russia are discussed, effectiveness of its long-term using on the base of the federal programs in developed European countries and America is analyzed; necessity and economic advisability of its introducing on the base of the federal and municipal programs in Russia from the evidence-based medicine point of view are considered, indications and arguable points of the program are discussed.

scholarly journals Is the Prescription of Antidepressants for Bipolar Depression Justified from the Point of View of Evidence-Based Medicine?

Psychiatry ◽  
2020 ◽  
Vol 18 (2) ◽  
pp. 51-60
Author(s):  
S. S. Potanin ◽  
M. A. Morozova
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Bipolar Depression ◽  
Routine Clinical Practice ◽  
Point Of View ◽  
Response To Therapy ◽  
Mood Stabilizers ◽  
Evidence Based ◽  
Based Medicine ◽  
High Degree

Background: prescribing antidepressants in the treatment of bipolar depression remains highly controversial due to the inconsistence between routine clinical practice and the results of controlled trials. Purpose: to assess the validity of antidepressants use in bipolar depression from the point of view of evidence-based medicine. Material: database search (Scopus and MEDLINE) followed by analysis of studies concerning the efficacy and safety of antidepressants in bipolar depression treatment. Сonclusion: the search found 23 studies. There was a high degree of inconsistency in the results, apparently related to the methodology. Only two studies compared the effectiveness of antidepressants in monotherapy with placebo, with no differences found in the study with 740 participants and in the study with 70 participants with type 2 bipolar disorder antidepressants were found to be more effective than placebo. Nevertheless, both studies had significant methodological issues. In 6 studies comparing the effectiveness of the combination of antidepressants with mood stabilizers against the combination of mood stabilizers with placebo, only the effectiveness of fluoxetine in combination with olanzapine was revealed, other antidepressants were ineffective. At the same time, studies where antidepressants were compared with each other in combination with mood stabilizers revealed a significant clinical response to therapy. Analysis of routine clinical practice studies has shown that antidepressants are prescribed very often, for about 50% of patients with bipolar depression. International guidelines for therapy differ quite widely on the use of antidepressants in bipolar depression, but in principle allow their use. Thus, despite the contradictory literature data, the use of antidepressants in bipolar depression is justified from the point of view of evidence-based medicine for certain groups of patients with taking into account risk factors.

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