scholarly journals Współczesne kierunki rehabilitacji w zespołach bólowych kręgosłupa lędźwiowo-krzyżowego – przegląd systematyczny

2018 ◽  
Vol 64 (3) ◽  
Author(s):  
Wioletta Łubkowska ◽  
Bożena Mroczek
Keyword(s):  
Evidence Based Medicine ◽  
Google Scholar ◽  
Cochrane Library ◽  
Evidence Based ◽  
Based Medicine

ABSTRAKT Wstęp: Zespoły bólowe kręgosłupa lędźwiowo-krzyżowego ze względu na powszechność zjawiska oraz coraz młodszy wiek pacjentów uznaje się za schorzenie cywilizacyjne. Celem artykułu była krytyczna analiza dostępnych wytycznych, raportów i dowodów dostarczających argumentów dotyczących postępowania diagnostyczno-terapeutycznego w bólach krzyża. W pracy przedstawiono epidemiologię, etiologię, diagnozę oraz wybrane metody leczenia i profilaktyki bólu krzyża. Materiały i metody: Dokonano przeglądu danych literaturowych w oparciu o bazę komputerową Polska Bibliografia Lekarska oraz anglojęzyczną bazę danych PubMed i Cochrane Library. Dodatkowo wykorzystano wyszukiwarkę Google Scholar. Prezentowane prace przeanalizowano pod względem ich referencyjności naukowej i zgodności z zasadami Evidence-Based Medicine. W celu uzyskania rekomendacji na najwyższym poziomie w przeglądzie zostały uwzględnione aktualne dowody naukowe oparte na recenzowanych publikacjach naukowych, przeglądach systematycznych, metaanalizach i przeprowadzonych randomizowanych badaniach kontrolnych. Wyniki: Według licznych badań leżenie w łóżku jest nieskuteczne i nie powinno być zalecane. Literatura w odniesieniu do wpływu akupunktury, TENS, terapii zimnem i trakcji (wyciąg) na leczenie bólu krzyża jest zbyt niejednorodna i potrzebne są dalsze wysokiej jakości badania, zanim jakikolwiek końcowy wniosek zostanie postawiony. Mocno rekomendowane w leczeniu objawów bólu krzyża są: ćwiczenia fizyczne, terapia manualna oraz edukacja. Wnioski: Konieczne są dalsze badania w celu zidentyfikowania skutecznych niefarmakologicznych metod leczenia bólu krzyża oraz zrozumienia dodatkowych korzyści wynikających z łączenia poszczególnych interwencji, a także tego, które kombinacje leczenia i sekwencje są najbardziej skuteczne.

scholarly journals Efetividade da tomografia de impedância elétrica torácica na monitorização de pacientes em ventilação mecânica

2020 ◽  
Vol 5 (1) ◽  
pp. 16-36
Author(s):  
Roberto Carlos Silva ◽  
Carlos Roberto Silva ◽  
Antônio Peregrino ◽  
Cristiane Oliveira ◽  
Cristiano Marta
Keyword(s):  
Evidence Based Medicine ◽  
Google Scholar ◽  
Cochrane Library ◽  
Evidence Based ◽  
Based Medicine

Objetivos: avaliar a efetividade da Tomografia de Impedância Elétrica Torácica. Método: Parecer Técnico Científico nos moldes de uma revisão sistemática. As buscas foram feitas no mês de agosto de 2017, nas bases de dados Cochrane Library, MEDLINE (Via Portal PUBMED), BVS, ECRI Institute, PEDRo, EMBASE, Banco de Teses e Dissertações da CAPES e Google Scholar. Resultados: Foram incluídos 14 estudos que mostraram que, muito embora possam existir limitações acerca do uso do TIE para a monitorização pulmonar, sobretudo relacionado à baixa resolução espacial e a necessidade de calibração, a tecnologia parece fornecer informações únicas sobre mecânica pulmonar regional, possibilitando, portanto, que a equipe possa avaliar o suporte ventilatório, otimizando-o para evitar o estresse fisiológico e a tensão do parênquima pulmonar, particularmente em doentes em uso de PEEP. Conclusão: Não foram encontradas evidências sobre a efetividade do TIE na redução do tempo de internação e do tempo de ventilação mecânica invasiva. As evidências foram avaliadas como Grau de Recomendação B e C, segundo o Nível de Evidência de Oxford Centre for Evidence Based Medicine) e a recomendação foi fraca a favor da tecnologia. Palavras chave: Monitoramento. Respiração Artificial. Efetividade

scholarly journals Revisão sistemática: uma revisão narrativa

2007 ◽  
Vol 34 (6) ◽  
pp. 428-431 ◽  
Author(s):  
Alexander Magno Cordeiro ◽  
Glória Maria de Oliveira ◽  
Juan Miguel Rentería ◽  
Carlos Alberto Guimarães
Keyword(s):  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Meta Analysis ◽  
Google Scholar ◽  
Cochrane Library ◽  
Publication Date ◽  
Evidence Based ◽  
Publication Type ◽  
Based Medicine

OBJETIVO: realizar uma revisão narrativa sobre revisão sistemática. FONTE DOS DADOS: foi realizada busca no Cochrane Methodology Register, na Medline, na LILACS, no Google Scholar e na Cochrane Library, no período de 2000 a janeiro de 2007. Foram utilizados a busca manual das listas de referências e os contatos pessoais. SELEÇÃO DOS ESTUDOS: a estratégia de busca empregou, na Medline, as seguintes combinações dos termos MeSH: "Meta-Analysis" [Publication Type] AND "Evidence-Based Medicine"[MeSH] Limits: Publication Date from 2000 to 2007, Humans, Systematic Reviews. Na LILACS: (metanalise) or "metanalise" [Descritor de assunto] and [ medicina baseada em evidências] or "medicina baseada em evidências" [Descritor de assunto]. No Cochrane Methodology Register e no Google Scholar: "revisão sistemática e metanálise" e "medicina baseada em evidências". Após uma revisão independente por dois revisores, dez artigos que se referiam ao objetivo proposto foram selecionados. SÍNTESE DOS DADOS: os temas mencionados nos estudos foram agrupados em duas categorias: aqueles que se reportavam à história da revisão sistemática e aqueles que definiam Medicina Baseada em Evidência, revisão sistemática e metanálise. CONCLUSÃO: os autores concluem com a necessidade de mais discussões sobre revisão sistemática entre os cirurgiões.

The Commitment of the Documentation Service of the Swiss Academy of Medical Sciences for the Impartment of Evidence Based Medicine

Swiss Surgery ◽  
1999 ◽  
Vol 5 (4) ◽  
pp. 183-185
Author(s):  
Bleuer
Keyword(s):  
Evidence Based Medicine ◽  
Cochrane Library ◽  
Evidence Based ◽  
Medical Sciences ◽  
Based Medicine

Die mit dem Aufkommen der elektronischen Medien einhergehende Informationsflut hat die Erwartungen an den Dokumentationsdienst (DOKDI) der Schweizerischen Akademie der Medizinischen Wissenschaften verändert: Insbesondere Evidence Based Medicine (EBM) verlangt nicht nur die Beschaffung von Information, sondern auch eine Selektion hinsichtlich Qualität und Relevanz: Die sich aus der klinischen Situation ergebende Frage fordert eine Antwort, die inhaltlich richtig ist und in der konkreten Situation auch weiterhilft. Dem Ideal, sich durch kritische Lektüre der Originalarbeiten ein Bild über die vorhandene Evidenz für die Richtigkeit eines bestimmten Prozederes zu verschaffen, stehen in der Praxis meist Zeitmangel und methodische Schwierigkeiten im Weg; man wird sich deshalb oft auf die durch andere erarbeitete Evidenz abstützen müssen und z.B. die Cochrane Library konsultieren. Der DOKDI engagiert sich sowohl bei der Erarbeitung von systematischen Übersichtsarbeiten als auch bei der Dissemination der gefundenen Evidenz, indem er seine Erfahrung in der Dokumentation mit elektronischen Medien und die entsprechende Infrastruktur zur Verfügung stellt. Als Ergänzung zu diesen Aktivitäten hat die Akademie einen Grant zur Ausbildung von EBM-Tutoren gesprochen. In einem einwöchigen Kurs in Oxford werden Kliniker zu EBM-Tutoren ausgebildet: Dies wird zukünftig ermöglichen, vermehrt EBM-Workshops in der Schweiz durchzuführen.

Attitudes to, and Use of, Evidence-based Medicine in two Sydney Divisions of General Practice

2006 ◽  
Vol 12 (1) ◽  
pp. 40 ◽  
Author(s):  
Joanne L Callen ◽  
Kate Fennell ◽  
Jean H McIntosh
Keyword(s):  
General Practice ◽  
Evidence Based Medicine ◽  
Time Pressure ◽  
Response Rate ◽  
Postal Survey ◽  
Cochrane Library ◽  
Evidence Based ◽  
Royal Australian College ◽  
Australian General Practice ◽  
Based Medicine

Previous surveys suggested Australian GPs felt positive towards evidence-based medicine (EBM) but had reservations about practising it. Strategies to promote EBM in Australian general practice were implemented by the Royal Australian College of General Practitioners (RACGP) and published online in 1998. The aim of this study was to explore attitudes to and use of EBM in a population of Sydney GPs four years after publication of the strategies. A postal survey was conducted in 2003 among a group of GPs in Sydney (n=135) with a response rate of 31%. The survey assessed: attitudes to and barriers to practising EBM; preferred methods in moving from opinion-based medicine to EBM; awareness and use of EBM resources; and ability to interpret research evidence. Two- thirds of respondents felt positive towards EBM. Time pressure was the most commonly perceived barrier to practising EBM and use of evidence-based guidelines was the most popular method in moving towards EBM. Among 70% of respondents, at least 40% of clinical practice was evidence-based. Awareness of the databases The Cochrane Library and Medline was high, but use of database information was rare. There was partial understanding of technical terms used in EBM. While overall these GPs had a positive attitude towards EBM, they indicated some reluctance to applying it. Thus it is probable that in this GP group EBM was used less than optimally. The evidence provided by this study suggests that the RACGP strategies to promote appropriate use of EBM in general practice need heightened emphasis among the GPs surveyed. The study's low response rate prevents any generalisation of findings to the Australian general practice workforce.

scholarly journals What are the links between evidence-based medicine and shared decision-making in training programs for junior doctors? A scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e037225
Author(s):  
Mary Simons ◽  
Frances Rapport ◽  
Yvonne Zurynski ◽  
Jeremy Cullis ◽  
Andrew Davidson
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Scoping Review ◽  
Evidence Based Medicine ◽  
Cochrane Library ◽  
Junior Doctors ◽  
Evidence Based ◽  
Shared Decision ◽  
Patient Centred Care ◽  
Based Medicine

IntroductionPatient-centred care is pivotal to clinical practice and medical education. The practice of evidence-based medicine (EBM) and shared decision-making (SDM) are complementary aspects of patient-centred care, but they are frequently taught and reported as independent entities. To effectively perform all steps of EBM, clinicians need to include patients in SDM conversations, however, the uptake of this has been slow and inconsistent. A solution may be the incorporation of SDM into EBM training programmes, but such programmes do not routinely include SDM skills development. This scoping review will survey the literature on the kinds of EBM and SDM educational programmes that exist for recently qualified doctors, programmes that incorporate the teaching of both EBM and SDM skills, as well as identifying research gaps in the literature.Methods and analysisLiterature searches will be conducted in the databases Medline, Embase, Scopus and Cochrane Library. Bibliographies of key articles and their citing references will also be hand-searched and assessed for inclusion. Selected grey literature will be included. Papers must be written in English, or provide English abstracts, and date from 1996 to the present day.Two independent reviewers will screen titles and abstracts, check full texts of selected papers for eligibility and extract the data. Any disagreement will be resolved, and consensus reached, if necessary, with the assistance of a third reviewer. Qualitative and quantitative studies that address educational interventions for either EBM, SDM or both will be included. Data extraction tables will present bibliographic information, populations, interventions, context and outcomes. Data will be summarised using tables and figures and a description of findings.Ethics and disseminationThis review will synthesise information from publicly available publications and does not require ethics approval. The results will be disseminated via conference presentations and publications in medical journals.

scholarly journals Influência da concentração de condicionamento do ácido hidrofluorídrico na adesão protética de cerâmicas vítreas: uma revisão sistemática

2021 ◽  
Vol 10 (2) ◽  
pp. e7810212093
Author(s):  
Millena Silva Cardoso ◽  
Laís Ferrante de Faria ◽  
Camila Moreira Lima ◽  
Fabíola Pessôa Pereira Leite ◽  
Laércio Almeida de Melo
Keyword(s):  
Acid Concentration ◽  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Hydrofluoric Acid ◽  
Web Of Science ◽  
Cochrane Library ◽  
Evidence Based ◽  
Ceramic Surface ◽  
Based Medicine

Objetivo: O objetivo dessa revisão sistemática foi avaliar a influência das diferentes concentrações do ácido hidrofluorídrico (HF) no condicionamento das cerâmicas vítreas. Materiais e Métodos: Esta revisão reuniu estudos in vitro a partir de buscas nas bases Cochrane Library, Lilacs, PubMed, SciElo, Scopus e Web of Science, através dos descritores “Veneers”, “Crowns”, “Ceramics”, “Ceramic”, “Surface Treatments”, “Surface”, “Hydrofluoric Acid Concentration”, “Acid Concentration”, “Adhesion”, “Hydrofluoric Acid”. Foram incluídos estudos que investigaram os efeitos da concentração do ácido hidrofluorídrico através de diferentes concentrações entre grupos. O nível de evidência dos artigos selecionados seguiu os princípios do Oxford Center for Evidence-Based Medicine. Esta revisão seguiu as recomendações do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyzes). Resultados: As estratégias de busca encontraram 151 títulos, dos quais 8 foram eleitos e incluídos nessa revisão. Os parâmetros de avaliação incluíram a influência da concentração do ácido quanto a resistência a flexão, rugosidade superficial, ângulo de molhamento e resistência ao microcisalhamento. Nos estudos, as cerâmicas foram condicionadas com diferentes tipos de concentração e, no geral, o HF a 5% teve o melhor desempenho. Conclusão: Os estudos encontraram mais resultados negativos para as concentrações mais baixas (1% e 3%). Apesar de algumas vantagens, o HF a 10% também não teve os melhores resultados, os quais foram de autoria do HF a 5%. Além disso, a concentração não pode ser vista como o único e principal fator importante na qualidade de adesão das cerâmicas.

scholarly journals Awareness and the use of evidence-based medicine resources among physicians

2019 ◽  
Vol 6 (10) ◽  
pp. 4612-4614
Author(s):  
Amjad Alhelo ◽  
Bashar Samara
Keyword(s):  
Evidence Based Medicine ◽  
Best Practice ◽  
Response Rate ◽  
Cross Sectional Study ◽  
Cochrane Library ◽  
Evidence Based ◽  
Cross Sectional ◽  
Evidenced Based ◽  
The Cochrane Library ◽  
Based Medicine

Aim: to evaluate awareness and the use of evidence-based medicine resources among physicians in Jordan.  Method: A cross-sectional study by internet was performed among 517 doctors who were responsive from a total of 717 doctors, a total of 72.1% response rate. Doctors from all specialties were contacted from a Facebook group called doctors café in Jordan. A questionnaire was given to each one of them to measure their awareness and use of Evidence based database.   Result: From 517 physicians 377 they are using evidenced based resources frequently, and 91 using resources but not frequently and 49 not using evidence-based resources. The resource that was mostly used by the doctors was PubMed, followed by other resources such as Up to date, National Guideline Clearinghouse, Medscape, BMJ best practice, e-books and other online journals for published papers. The Cochrane Library was surprisingly not so familiar amongst physicians. Conclusion: There is good awareness about EBM among physicians in Jordan, and that benefits health care in Jordan.

scholarly journals Exercício físico na prevenção de quedas do idoso da comunidade: revisão baseada na evidência

2018 ◽  
Vol 12 (39) ◽  
pp. 1-11 ◽  
Author(s):  
Joana Rita Bento ◽  
Nadina Duarte Sousa
Keyword(s):  
Medical Association ◽  
Evidence Based Medicine ◽  
Accidental Falls ◽  
Prevention And Control ◽  
Falls Prevention ◽  
National Guideline ◽  
Cochrane Library ◽  
Evidence Based ◽  
Based Medicine ◽  
And Control

Introdução: A prevenção de quedas do idoso é um urgente desafio de saúde pública. O exercício físico tem-se comprovado uma intervenção preventiva eficaz. Objetivo: Rever a evidência científica mais recente, relativa à recomendação do exercício físico na prevenção de quedas do idoso da comunidade. Identificar modalidade física e regimes de frequência com maior benefício. Métodos: Efetuou-se uma pesquisa bibliográfica, utilizando os termos MeSH “aged”, “accidental falls/prevention and control” e “exercise”, nas bases de dados PubMed, Cochrane Library, National Guideline Clearinghouse, Canadian Medical Association, Evidence based Medicine e NICE Evidence Search, nos últimos 5 anos. Foram incluídos artigos que avaliassem o exercício como intervenção isolada na prevenção de quedas do indivíduo da comunidade, com ≥60 anos. Resultado avaliado: incidência de quedas. Resultados: De 637 potenciais artigos, 4 cumpriam critérios de inclusão: 2 ensaios clínicos aleatorizados controlados (ECACs), 1 estudo coorte e 1 meta-análise (MA). Globalmente, os resultados demonstram um efeito protetor do exercício físico. A MA obteve uma razão de taxas de incidência (RTI) de 0,79 (p<0,001), com o treino de equilíbrio (RTI=0,85, p=0,04) e maior dose semanal (RTI=0,77, p=0,03) a demonstrarem-se mais efetivos. Contrariamente, um ECAC demonstrou superioridade na marcha. O estudo coorte revelou maior benefício em participações ≥3 anos (RTI=0,90; p=0,03). Conclusão: O exercício físico é efetivo na prevenção de quedas do idoso da comunidade. Treinos de equilíbrio e práticas semanais ≥3 horas demonstraram melhores resultados (SORT A). A sua manutenção deve ser incentivada a longo prazo (SORT B).

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