Prevention of endometrial hyperplasia without atypia in women of reproductive age

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. 454-458
Author(s):  
Mekan R. Orazov ◽  
Ljudmila M. Mihaleva ◽  
Roman E. Orekhov ◽  
Irina A. Mullina
Keyword(s):  
Endometrial Hyperplasia ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Reproductive Age ◽  
Systematic Analysis ◽  
The Past ◽  
Therapeutic Benefits ◽  
Wide Range ◽  
Personalized Approach ◽  
Excessive Proliferation

Objective of this review is a systematic analysis of the data available in the current literature on the efficacy and safety of progestogens for the prevention of atypical endometrial hyperplasia (EH) in patients of reproductive age. EH is an excessive proliferation that results in increased volume and changes in endometrial tissue architectonics with an increase in the endometrial glands to stroma ratio of more than 1:1. This review will consider the use of progestogens for the prevention of (EH) based on evidence-based scientific evidence over the past 5 years. The expansion of the range of effective treatment options allows the adaptation of treatment to the needs of patients and offers a personalized approach to their management. Progestogens are an effective and safe method for the prevention of atypical hyperplasia, with a wide range of therapeutic benefits associated with reliable favorable fertility prognosis, especially in young women.

scholarly journals Awareness and perceptions of clinical guidelines for the diagnostics and treatment of severe behavioural problems in children across Europe: A qualitative survey with academic experts

2019 ◽  
Vol 57 ◽  
pp. 1-9 ◽  
Author(s):  
Alexandra-Raluca Gatej ◽  
Audri Lamers ◽  
Lieke van Domburgh ◽  
Matty Crone ◽  
Terje Ogden ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Practice Guidelines ◽  
Clinical Guidelines ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Behavioural Problems ◽  
Clinical Practices ◽  
Clinical Document ◽  
Current Prevalence ◽  
Wide Range

AbstractBackground:Severe behavioural problems (SBPs) in childhood are highly prevalent, impair functioning, and predict negative outcomes later in life. Over the last decade, clinical practice guidelines for SBPs have been developed across Europe to facilitate the translation of scientific evidence into clinical practice. This study outlines the results of an investigation into academic experts’ perspectives on the current prevalence, implementation, and utility of clinical guidelines for SBPs in children aged 6–12 across Europe.Methods:An online semi-structured questionnaire was completed by 28 psychiatry and psychology experts from 23 countries.Results:Experts indicated that approximately two thirds of the included European countries use at least an unofficial clinical document such as textbooks, while nearly half possess official guidelines for SBPs. Experts believed that, although useful for practice, guidelines’ benefits would be maximised if they included more specific recommendations and were implemented more conscientiously. Similarly, experts suggested that unofficial clinical documents offer a wide range of treatment options to individualise treatment from. However, they stressed the need for more consistent, evidence-based clinical practices, by means of developing national and European clinical guidelines for SBPs.Conclusions:This study offers a preliminary insight into the current successes and challenges perceived by experts around Europe associated with guidelines and documents for SBPs, acting as a stepping stone for future systematic, in-depth investigations of guidelines. Additionally, it establishes experts’ consensus for the need to develop official guidelines better tailored to clinical practice, creating a momentum for a transition towards European clinical guidelines for this population.

Branch Retinal Vein Occlusion – Update on Treatment Options

2016 ◽  
Vol 10 (01) ◽  
pp. 25 ◽  
Author(s):  
Stephan Michels ◽  
Magdalena Anna Wirth ◽  
◽  
◽  
Keyword(s):  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Options ◽  
Diagnostic Methods ◽  
Evidence Based ◽  
The Past ◽  
Recommended Treatment ◽  
Vein Occlusion ◽  
Wide Range

The advent of new pharmacotherapeutic options and diagnostic methods have led to a revolution in the management of branch retinal vein occlusion over the past few years. Despite the variety of treatment options, we are confronted with several questions: which drug should we use? Is switching between or combining treatment options beneficial? What is the recommended treatment regimen? When should we start treatment and for how long should we continue it? Should we still use retinal laser therapy? The wide range of possibilities and emerging treatment choices not only aids, but also challenges clinicians striving for evidence-based management.

scholarly journals COMMENTS TO THE PRACTICAL USE OF THE RUSSIAN CLINICALRECOMMENDATIONS FOR OSTEOPOROSIS

2010 ◽  
Vol 13 (1) ◽  
pp. 34-46
Author(s):  
O. B. Ershova ◽  
O. V. Ershova
Keyword(s):  
Bone Fractures ◽  
Treatment Options ◽  
Economic Consequences ◽  
Prolonged Treatment ◽  
Osteoporotic Bone ◽  
Treatment Of Osteoporosis ◽  
The Past ◽  
Wide Range ◽  
High Prevalence ◽  
Osteoporosis Research

Osteoporosis is one of the most socially significant chronic noninfectious diseases. This is due to its high prevalence and medical, social and economic consequences from osteoporotic bone fractures. The problem of osteoporosis is intensively studied in Russia for the past 15 years. Taking into account the peculiarities of the osteoporotic process (gradual, protracted, oligosymptomatic beginning, multifactorial origin, need for prolonged treatment to achieve effectiveness, wide range of drug treatment options etc.) and remaining lack of knowledge and experience of practitioners in view of the swift progress in osteoporosis research, we consider the importance of unity in approach to diagnosis, prophylaxis and treatment of osteoporosis for doctors of all specialities. These prompted Russian experts to develop the first Russian Clinical Recommendations for osteoporosis that were published in 2005 and reviewed in 2009.

Diagnosis and investigation in suspected heart disease

2018 ◽  
Author(s):  
Colin Forfar
Keyword(s):  
Natural History ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Case Fatality ◽  
The Past ◽  
Good Patient Care ◽  
History Of ◽  
Coronary Syndromes ◽  
Complete Physical Examination ◽  
And Function

The past 20 years have seen significant changes in both the demographics and natural history of many cardiovascular diseases. Important reductions in case-fatality rates (such as in acute coronary syndromes) have resulted from improved diagnostics and treatment options and better understanding of natural history. For others (such as infective endocarditis), improvements have been limited and disappointing. While advances in therapy and the scientific evidence underpinning treatments have been crucial, the importance of accurate diagnosis has remained a key element for progress. Many of the principles needed for diagnosis are constant: the pre-eminence of a focused, accurate history, complete physical examination, and timely and relevant investigation endures. It is essential to have a secure knowledge of the strengths and limitations of interpretation of a frequently bewildering array of tests. Progress in this field has been rapid; advances in ultrasound, scintigraphy, and cardiac magnetic resonance stand out at the interface between structure and function central to good patient care.

Hormesis and radiation safety norms: Comments for an update

2018 ◽  
Vol 37 (11) ◽  
pp. 1233-1243 ◽  
Author(s):  
SV Jargin
Keyword(s):  
Ionizing Radiation ◽  
Low Dose ◽  
Radiation Safety ◽  
Dynamic Balance ◽  
Scientific Evidence ◽  
Epidemiological Studies ◽  
Radiation Background ◽  
Dna Damage And Repair ◽  
The Past ◽  
Wide Range

Hormesis can be explained by evolutionary adaptation to the current level of a factor present in the natural environment or to some average from the past. This pertains also to ionizing radiation as the natural background has been decreasing during the time of the life existence. DNA damage and repair are normally in a dynamic balance. The conservative nature of the DNA repair suggests that cells may have retained some capability to repair damage from higher radiation levels than that existing today. According to this concept, the harm caused by radioactive contamination would tend to zero with a dose rate tending to a wide range level of the natural radiation background. Existing evidence in favor of hormesis is substantial, experimental data being partly at variance with results of epidemiological studies. Potential bias, systematic errors, and motives to exaggerate risks from low-dose low-rate ionizing radiation are discussed here. In conclusion, current radiation safety norms are exceedingly restrictive and should be revised on the basis of scientific evidence. Elevation of the limits must be accompanied by measures guaranteeing their observance.

A Systematic Analysis of Examples of Modification by Subsequent Practice

2018 ◽  
Author(s):  
Irina Buga
Keyword(s):  
International Organizations ◽  
Dispute Settlement ◽  
Reference Points ◽  
Customary Law ◽  
Systematic Analysis ◽  
The Past ◽  
Wide Range ◽  
Future Reference ◽  
The Way

This chapter illustrates the treaty modifying potential of subsequent practice and customary law by means of a ‘repertoire’ of examples of practice spanning a wide range of legal fields, with a focus on major treaty regimes such as the UN Charter and the LOSC, and examples drawn from both within and outside the dispute settlement context, as well as within and outside the context of international organizations. The chapter systematically explores the modifying potential of subsequent practice in different contexts, facilitating identification and analysis of analogous cases. It combines and builds upon the analysis in the preceding chapters in order to derive—with the focus on international practice as such—guidelines that provide future reference points to better understand the modifying potential of subsequent practice, and examine the way in which modifications have been dealt with in the past, by dispute settlement bodies in particular.

scholarly journals Assessing the quantitative impact of ecosystem shifts on human societies

2020 ◽  
Author(s):  
Tatsuya Amano ◽  
Catherine E. Richards ◽  
William J Sutherland ◽  
Seán Ó hÉigeartaigh
Keyword(s):  
Coastal Waters ◽  
Scientific Evidence ◽  
Marine Ecosystem ◽  
Economic Consequences ◽  
Nutrient Inputs ◽  
Green Tides ◽  
The Past ◽  
Wide Range ◽  
Quantitative Impact ◽  
Broad Spatial Scale

A wide range of ecosystems have been reported to show abrupt and drastic shifts in their states. Such shifts in ecosystem states, typically known as regime shifts, are hardly predictable and not readily reversible once they have taken place, and can have considerable impacts on human societies that are dependent on those ecosystems. Nevertheless, earlier studies have rarely quantified the consequences of ecosystem shifts for human societies, instead focusing largely on identifying the occurrence of shifts, understanding drivers and mechanisms, and developing early warning signals for forecasting. We address this knowledge gap by searching for scientific evidence on the quantitative impacts of ecosystem shifts on human societies. Based on a set of pre-defined search criteria we identified a total of 92 papers that discussed particular ecosystem shifts and associated impacts. The number of papers reporting ecosystem shifts and associated impacts has considerably increased over the past 20 years, indicating a recent rise in the interest in the issue among scientific communities. The 92 papers reported state shifts in a wide range of ecosystems, with marine ecosystem shifts reported most frequently (in 22 papers), followed by shifts in wetland (18 papers) and forest (10 papers) ecosystems. Climate change was by far the most frequently reported driver of ecosystem shifts (reported in 32 papers), followed by land use change (12 papers) and nutrient inputs (nine papers). Only 17 (18%) out of the 92 papers described the quantitative consequences of ecosystem shifts for human societies. Estimated economic consequences ranged from 5 million US dollars per year relating to eutrophication of Swedish coastal waters, to costs of 200 billion US dollars linked to macro-algal green tides along the Qingdao coast. We found that our knowledge of quantitative impacts of ecosystem shifts on human societies is still severely limited, especially in terms of risks to human health and survival and, at a broad spatial scale, where multiple ecosystem shifts could interact to exacerbate the extent or severity of their impacts.

Optical Properties of HVEM Accelerators

1975 ◽  
Vol 33 ◽  
pp. 180-181
Author(s):  
A. Strojnik ◽  
J.W. Scholl ◽  
V. Bevc
Keyword(s):  
Optical Properties ◽  
Electron Accelerator ◽  
Systematic Investigation ◽  
Electron Source ◽  
High Brightness ◽  
The Past ◽  
Wide Range ◽  
Optical Behavior

The electron accelerator, as inserted between the electron source (injector) and the imaging column of the HVEM, is usually a strong lens and should be optimized in order to ensure high brightness over a wide range of accelerating voltages and illuminating conditions. This is especially true in the case of the STEM where the brightness directly determines the highest resolution attainable. In the past, the optical behavior of accelerators was usually determined for a particular configuration. During the development of the accelerator for the Arizona 1 MEV STEM, systematic investigation was made of the major optical properties for a variety of electrode configurations, number of stages N, accelerating voltages, 1 and 10 MEV, and a range of injection voltages ϕ0 = 1, 3, 10, 30, 100, 300 kV).

Endovenous procedures in varicose veins

Phlebologie ◽  
2008 ◽  
Vol 37 (05) ◽  
pp. 229-236
Author(s):  
N. Cayne ◽  
G. Jacobowitz ◽  
P. Lamparello ◽  
T. Maldonado ◽  
C. Rockman ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Treatment Options ◽  
Postoperative Recovery ◽  
Comparable Efficacy ◽  
Intense Pulse Light ◽  
Efficacy And Safety ◽  
Endovenous Laser Ablation ◽  
The Past ◽  
Early Evidence ◽  
Endovenous Treatment

SummaryOver the past ten years endoveous treatment options for varicose veins have evovled considerably, offering clinicians a multitude of options to meet the needs of their patients. The endothermal ablation procedures have moved to the forefront as the choice modality for treating truncal reflux. Both radiofrequency ablation and endovenous laser ablation are widely accepted and interchangeable, showing comparable efficacy and safety. Although numerous endovenous laser wavelengths exist, the data indicates that the differences do not affect the efficacy or postoperative recovery of the procedure. The endovenous laser innovation that has shown early evidence of improved patient outcome is the jacket-tip fiber. The versatility of sclerotherapy makes it a critical component in the endovenous treatment of varicosities. Although not approved by the Food and Drug Administration (USA), the use of a foamed sclerosing agent is the fastest growing segment of sclerotherapy and an important treatment modality in the future of varicose vein treatment. Cutaneous lasers and intense pulse light devices contribute a crucial element, enabling clinicians to treat minute veins that may be impossible to treat with other therapies.

Pursuit of the Abscopal Effect

2020 ◽  
Vol 04 (04) ◽  
pp. 369-372
Author(s):  
Paul B. Romesser ◽  
Christopher H. Crane
Keyword(s):  
Tumor Immunology ◽  
Antitumor Immunity ◽  
Clinical Success ◽  
Immune Recognition ◽  
Immune Modulators ◽  
Cancer Subtypes ◽  
The Past ◽  
Tumor Irradiation ◽  
Wide Range ◽  
Tumor Recognition

AbstractEvasion of immune recognition is a hallmark of cancer that facilitates tumorigenesis, maintenance, and progression. Systemic immune activation can incite tumor recognition and stimulate potent antitumor responses. While the concept of antitumor immunity is not new, there is renewed interest in tumor immunology given the clinical success of immune modulators in a wide range of cancer subtypes over the past decade. One particularly interesting, yet exceedingly rare phenomenon, is the abscopal response, characterized by a potent systemic antitumor response following localized tumor irradiation presumably attributed to reactivation of antitumor immunity.

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