scholarly journals DO PROBIOTICS HAVE A FUTURE IN NEONATOLOGY? (ANALYSIS OF THE LATEST DATA. PART 3)

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 45-52
Author(s):  
T. Znamenska ◽  
O. Vorobiova
Keyword(s):  
Working Group ◽  
Premature Newborns ◽  
Routes Of Administration ◽  
Randomized Controlled Clinical Trials ◽  
Treatment Standard ◽  
Transfer Genes ◽  
Probiotic Strains ◽  
Probiotic Product ◽  
Clinical Questions

The issue of feasibility and effectiveness of probiotics use in newborns is still discussable. A position letter of the Committee on nutrition of the European Society for Pediatric NutritionGastroenterology, Hepatology, and(ESPGHAN) and the Working group of the ESPGHAN on probiotics and prebiotics issues was published in May 2020 in “Pediatric Gastroenterology and Nutrition” magazine as for the use of probiotics in premature newborns. The third part of the literature continues with the position paper and the results of many randomized controlled clinical trials of probiotics. The article considers the answers to 6 clinical questions posed by the working group of the Committee to assess the feasibility of use, routes of administration, dosage and duration of use, as well as the effectiveness and quality of probiotic drugs. It was proved that probiotics, in general, could decrease the level of necrotising enterocolitis, sepsis, and mortality. On the other hand, an increasing number of commercial products containing probiotics of non optimal quality are available. In addition, a large number of departments in the world regularly suggest probiotic supplements as a treatment standard despite the absence of any solid evidence. Moreover, the emphasis was placed on issues of safety of probiotic supplements for premature newborns. Guarantee of quality of probiotic product is deliverance of probiotic strains by transfer genes of resistance to antibiotics, the ability to regularly detect sepsis while using probiotics.

scholarly journals DO PROBIOTICS HAVE A FUTURE IN NEONATOLOGY?

2021 ◽  
Vol 11 (3(41)) ◽  
pp. 46-54
Author(s):  
T. Znamenska ◽  
O. Vorobiova
Keyword(s):  
Necrotizing Enterocolitis ◽  
Meta Analysis ◽  
Streptococcus Thermophilus ◽  
Pediatric Gastroenterology ◽  
Premature Newborns ◽  
Treatment Standard ◽  
Transfer Genes ◽  
The World ◽  
Probiotic Strains ◽  
Probiotic Product

The issue of feasibility and effectiveness of probiotics use in newborns is still discussable. A position letter of the Committee on nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) and the Working group of the ESPGHAN on probiotics and prebiotics issues was published in May 2020 in “Pediatric Gastroenterology and Nutrition” magazine as for the use of probiotics in premature newborns. It stated that over 10,000 premature newborns from all over the world had taken part in random controlled probiotics tests. It was proved that probiotics, in general, could decrease the level of necrotizing enterocolitis, sepsis, and mortality. But the question of choice of microorganism strains, dosing, and duration of medication course remains open. On the other hand, an increasing number of commercial products containing probiotics of non optimal quality are available. In addition, a large number of departments in the world regularly suggest probiotic supplements as a treatment standard despite the absence of any solid evidence. According to the data of the latest meta-analysis, effectiveness in decreasing mortality and incidence was found in the minority of investigated strains or combinations. In the position letter authors wanted to give advice which specific strains can be potentially used and which cannot. Moreover, the emphasis was placed on issues of safety of probiotic supplements for premature newborns. Guarantee of quality of probiotic product is deliverance of probiotic strains by transfer genes of resistance to antibiotics and the possibility of regular identification of probiotic sepsis. There is a conditional recommendation (with a low credibility of evidence) to provide eitherLactobacillus rhamnosus GG ATCC53103, or combination of Bifidobacterium infantis Bb-02, Bifidobacterium lactis Bb-12, and Streptococcus thermophilus TH-4 for decreasing a risk of the necrotizing enterocolitis development subject to all issues of safety. 

scholarly journals Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (8) ◽  
pp. 3991
Author(s):  
Antonio Jose Martin-Perez ◽  
María Fernández-González ◽  
Paula Postigo-Martin ◽  
Marc Sampedro Pilegaard ◽  
Carolina Fernández-Lao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastasis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Vertebral Metastasis ◽  
Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

Modernization in GUM/HIV services: what does it mean?

2003 ◽  
Vol 14 (2) ◽  
pp. 89-98 ◽  
Author(s):  
Angela J Robinson ◽  
Karen Rogstad
Keyword(s):  
Quality Of Service ◽  
Sexually Transmitted Infections ◽  
21St Century ◽  
Working Group ◽  
Local Population ◽  
Hiv Services ◽  
Sexually Transmitted ◽  
Measuring Outcomes ◽  
Genitourinary Medicine

Genitourinary medicine services are expected to modernize in order to meet the needs of the NHS in the 21st century. Although increased funding is essential, there is a need for services to look at new ways of delivering care in order to deal with the increasing rate of sexually transmitted infections (STIs) including HIV in the community. This must include a review of skill-mix and roles. Some changes may appear to lower the quality of service. There must be auditing of changes to ensure that standards are not lowered. A short-lived working group was put together at the request of the RCP joint speciality committee for GUM consisting of representatives from diverse GUM clinics which have all been involved in extensive modernization of their service in order to meet demand. This report does not hold all the answers but provides suggestions for clinics wishing to initiate change. Changes must be appropriate to the local population and access pressures. More extreme measures may only be appropriate in the most severely stretched clinics and with consideration of measuring outcomes.

Health and Medical Informatics Competencies: Call to Participate in Updating the IMIA Recommendations

2002 ◽  
Vol 41 (02) ◽  
pp. 86-88 ◽  
Author(s):  
Judith Douglas ◽  
Evelyn Hovenga
Keyword(s):  
Literature Review ◽  
Small Group ◽  
Learning Outcomes ◽  
Medical Informatics ◽  
Working Group ◽  
International Medical ◽  
Three Dimension ◽  
Virtual University ◽  
Group 1

Summary Objectives: On behalf of the International Medical Informatics Association (IMIA), its Working Group 1 (WG1) addresses health and medical informatics education. Methods: As part of its mission, WG1 developed recommendations for competencies, describing a three-dimension framework and defining learning outcomes. Results: Officially approved by IMIA in 1999, the recommendations have been translated into seven languages. In 2001, WG1 charged a small group with updating the recommendations and consider the work undertaken by others to develop competencies. Additional work underway in support of the recommendations includes a literature review to help extract the fundamental competencies from the recommendations. To ensure the highest quality of input in the updated recommendations, WG1 is issuing a call for participation to the international informatics community. Conclusions: Further work with the competencies will result in updated IMIA guidelines. These are expected to support the creation of a virtual university for health and medical informatics.

scholarly journals Development of a Best Practice Statement on the Use of Ankle-Foot Orthoses Following Stroke in Scotland

2010 ◽  
Vol 34 (3) ◽  
pp. 245-253 ◽  
Author(s):  
Roy Bowers ◽  
Karyn Ross
Keyword(s):  
Health Service ◽  
Working Group ◽  
Best Practice ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
Expert Working Group ◽  
Health Service Quality ◽  
The Impact ◽  
Successes And Challenges

A National Health Service Quality Improvement Scotland (NHS QIS) scoping exercise in 2007 identified the use of ankle-foot orthoses (AFOs) following stroke as a clinical improvement priority, leading to the development of a best practice statement (BPS) on AFO use after stroke. This paper outlines the development process of the BPS which is available from NHS QIS. The authors were involved as part of a working group that included practitioners from the fields of orthotics, physiotherapy, stroke nursing and bioengineering, staff of NHS QIS and a patient representative. In consultation with an NHS QIS health services researcher, the authors undertook a systematic literature review to evidence where possible the recommendations made in the BPS. Where evidence was unavailable, consensus was reached by the expert working group. As the BPS was designed for the non-specialist and non-orthotic practitioner the authors also developed educational resources which were included within the BPS to aid the understanding of the principles underpinning orthotic design and prescription. The BPS has been widely distributed throughout the health service in Scotland and is available electronically at no cost via the NHS QIS website. As part of an ongoing evaluation of the impact of the BPS on the quality of orthotic provision, NHS QIS has invited feedback regarding successes and challenges to implementation.

scholarly journals Effects of Neural Mobilization Techniques on Painand Disabilityin PatientsWith Neurodynamic Dysfunction: A Systematic Review of Randomized Controlled Trials

2021 ◽  
Author(s):  
Hasan Shamsi ◽  
Khosro Khademi-Kalantari ◽  
Farshad Okhovatian
Keyword(s):  
Clinical Trials ◽  
Nervous System ◽  
Randomized Clinical Trials ◽  
Tension Type Headache ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Level 3 ◽  
Tunnel Syndrome ◽  
Type Headache

Introduction: Neural mobilization is the most important  technique  used for the treatment  of nervous system dysfunction. This study aimed to systematically review and evaluate the therapeutic efficacy of neural mobilization techniques in nervous system dysfunctions by assessing Randomized Controlled Clinical Trials (RCTs). Materials and Methods: We used all English papers published in five electronic databases from 2000 to 2020 using the following keywords: “neural mobilization”, “nerve mobilization”, “physical therapy”, “nerve glide exercises”, “neural stretching”, “neurodynamics”, and “neural physiotherapy”. The full text of the articles identified was reviewed to select papers specifically discussing neural mobilization as a treatment modality. The PEDro scale was used to assess the quality of these trials. The randomized clinical trials were selected that examined the therapeutic effect of neural mobilization. Results: Twelve RCTs were identified. Five RCTs used the same median nerve tensioning technique in patients  with Carpal Tunnel  Syndrome  (CTS).  In some studies, the methods  of neural mobilization were different. Fourteen papers examined different neurodynamic dysfunctions such as lateral epicondylalgia, radicular neck pain, postoperative spinal surgery, radicular low back pain, and chronic tension-type headache. There is moderate evidence (Level 2) to support distal nerve tensioning and tendon gliding techniques in CTS Also, there was limited (Level 3) and insufficient (Level 4) evidence about using cervical lateral gliding away from their involved side and upper limb tension test mobilization and the use of slump stretches and combinations techniques in the treatment of neurodynamic dysfunction, respectively. Besides, all studies reported a positive effect compared to neutral effects. Conclusion: Although clinicians frequently use neuromobilization techniques for both diagnosis and treatment of nervous system dysfunctions, the quality assessment of 20 RCTs has shown insufficient evidence to support the efficacy of these techniques in the treatment of nervous system dysfunctions.

scholarly journals Management of Pyrexia Associated with the Combination of Dabrafenib and Trametinib: Canadian Consensus Statements

2021 ◽  
Vol 28 (5) ◽  
pp. 3537-3553
Author(s):  
Alia Thawer ◽  
Wilson H. Miller ◽  
Nancy Gregorio ◽  
Joël Claveau ◽  
Sudha Rajagopal ◽  
...  
Keyword(s):  
Working Group ◽  
Treatment Algorithm ◽  
Practice Variation ◽  
Routine Practice ◽  
Group Consensus ◽  
Therapeutic Approaches ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Consensus Statements

The combination of dabrafenib and trametinib is a well-established treatment for BRAF-mutated melanoma. However, the effectiveness of this approach may be hindered by the development of treatment-related pyrexia syndrome, which occurs in at least 50% of treated patients. Without appropriate intervention, pyrexia syndrome has the potential to worsen and can result in hypotension secondary to dehydration and associated organ-related complications. Furthermore, premature treatment discontinuation may result in a reduction in progression-free and overall survival. Despite existing guidance, there is still a wide variety of therapeutic approaches suggested in the literature for both the definition and management of dabrafenib and trametinib-related pyrexia. This is reflected in the practice variation of its prevention and treatment within and between Canadian cancer centres. A Canadian working group was formed and consensus statements were constructed based on evidence and finalised through a two-round modified Delphi approach. The statements led to the development of a pyrexia treatment algorithm that can easily be applied in routine practice. The Canadian working group consensus statements serve to provide practical guidance for the management of dabrafenib and trametinib-related pyrexia, hopefully leading to reduced discontinuation rates, and ultimately improve patients’ quality of life and cancer-related outcomes.

scholarly journals Biochemical changes and physiological quality of corn seeds subjected to different chemical treatments and storage times

2020 ◽  
Vol 42 ◽  
Author(s):  
Thiago Lucas de Oliveira ◽  
Renzo Garcia Von Pinho ◽  
Heloisa Oliveira dos Santos ◽  
Karen Marcelle de Jesus Silva ◽  
Elise de Matos Pereira ◽  
...  
Keyword(s):  
Superoxide Dismutase ◽  
Alcohol Dehydrogenase ◽  
Cold Test ◽  
Chemical Treatments ◽  
Treatment Standard ◽  
Quality Markers ◽  
Physiological Quality ◽  
Storage Times ◽  
And Storage

Abstract: The chemical treatment of corn seeds is widely adopted for protecting crops at the early stages. However, some molecules interfere in the quality of seeds, especially when stored, by accelerating their deterioration. The objective of this work was to investigate the influence of insecticides on the enzymatic expression and quality of corn seeds subjected to storage. Seeds of the hybrids 2B647PW and SHS4070 were subjected to four different chemical treatments (standard treatment, standard + clothianidin, standard + thiamethoxam, and standard + fipronil) and stored for different periods (0, 3, 6, and 9 months). The quality evaluation included the germination test, first germination count, cold test, and health test. The expression of the enzymes α-amylase, esterase, superoxide dismutase, catalase, and alcohol dehydrogenase were determined by the gel electrophoresis technique. The insecticides clothianidin, thiamethoxam, and fipronil reduce the physiological quality of the seeds of hybrid 2B647PW after nine months of storage. The treatment of seeds with the insecticides clothianidin, thiamethoxam, and fipronil reduces the expression of α-amylase, superoxide dismutase, and catalase enzymes after nine months of storage. The enzymes α-amylase, superoxide dismutase, catalase, and alcohol dehydrogenase are good quality markers for hybrid corn seeds.

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