Historical Aspects of the Development of the State Educational System in the Field of Clinical Toxicology in Russia

Summary. The analysis of the historical development of the state system of training in the field of clinical toxicology showed that the opening of the first specialized departments (centers) served as an impulse for the adoption in the future of appropriate organizational decisions and regulatory documents that led to the creation of the country’s first department of clinical toxicology. In addition, this became possible after the emergence of qualified personnel of clinical toxicologists, as well as scientific and practical areas, primarily general resuscitation and toxicological chemistry, and the achievements of fundamental sciences, new pharmacological and technical means of detoxification of the body, on which basis educational materials of the proper level were formed.An important role for the creation of the Department of Clinical Toxicology was played by the publication by E.A. Luzhnikov, the country’s first textbook on clinical toxicology. The results of the activities of Academician E.A. Luzhnikov in the organization of training in the field of clinical toxicology also contributed to the acquisition of a comprehensive level of knowledge and the expansion of teaching in this direction.However, today, clinical toxicology has not become a basic specialty in the vast majority of medical institutions of higher education, including Moscow, which, in our opinion, hinders the process of training the required number of practical, scientific, and teaching personnel in this area.The choice of clinical bases for training is of fundamental importance, of which multidisciplinary research emergency hospitals or emergency hospitals are optimal.Along with the proven form of teaching in the form of field cycles, further reflection requires the place of distance learning as another approach to expanding the audience of listeners. It is also absolutely necessary to support the teaching process within the framework of continuous professional education, including cooperation with scientific and practical medical societies.The most important component of the learning process is the accumulation of scientific experience in the specialty, to which a decisive contribution is made by the creation of scientific schools on the bases of toxicological subdivisions. Additional opportunities are also provided by the modern formation of the scientific specialty “Toxicology”, which makes it possible to achieve the most qualified examination of the results of scientific research.Conclusion.The development of the state educational system in the field of clinical toxicology in Russia is closely related to its formation as an independent scientific and practical direction in medicine, which has high social significance, and the adoption of the experience gained in the course of educational activities.

A Protocol for the Use of Case Reports/Studies and Case Series in Systematic Reviews for Clinical Toxicology

Introduction: Systematic reviews are routinely used to synthesize current science and evaluate the evidential strength and quality of resulting recommendations. For specific events, such as rare acute poisonings or preliminary reports of new drugs, we posit that case reports/studies and case series (human subjects research with no control group) may provide important evidence for systematic reviews. Our aim, therefore, is to present a protocol that uses rigorous selection criteria, to distinguish high quality case reports/studies and case series for inclusion in systematic reviews.Methods: This protocol will adapt the existing Navigation Guide methodology for specific inclusion of case studies. The usual procedure for systematic reviews will be followed. Case reports/studies and case series will be specified in the search strategy and included in separate sections. Data from these sources will be extracted and where possible, quantitatively synthesized. Criteria for integrating cases reports/studies and case series into the overall body of evidence are that these studies will need to be well-documented, scientifically rigorous, and follow ethical practices. The instructions and standards for evaluating risk of bias will be based on the Navigation Guide. The risk of bias, quality of evidence and the strength of recommendations will be assessed by two independent review teams that are blinded to each other.Conclusion: This is a protocol specified for systematic reviews that use case reports/studies and case series to evaluate the quality of evidence and strength of recommendations in disciplines like clinical toxicology, where case reports/studies are the norm.