Evidence-based Medicine Protocols Research Articles

THIRTY YEARS OF EXPERIENCE IN APPLYING APPHYTOCOMPOSITIONS IN MEDICAL PRACTICE

Introduction. The results of 30 years of experience in the development, research, use of food products – dietary supplements-apiphytocompositions, their medical and biological evaluation and effectiveness in medical practice are presented. Apiphytocompositions were used as a food product in the complex therapy of diseases of the gastrointestinal tract, in particular, in patients who lived in areas of radiation control or were exposed to radioactive radiation; in infectious pathology – acute intestinal infections, hepatitis, acute respiratory diseases. The goal of the work. To evaluate medical and biological properties and effectiveness of dietary supplements-apiphytocompositions in medical practice based on thirty years of experience. Materials and methods of research. An analysis of the state of health of people aged 16 to 60 living in environmentally contaminated areas, in radiation control zones, evicted from areas of mandatory and guaranteed resettlement. Determination of incorporated radionuclides was determined by human impulse counter (QBM-1). Determination of the content of lipid peroxidation products and superoxide dismutase activity in the blood was performed according to standard methods. Results of research and discussion. Over 30 years, more than 20 combined food products of dietary supplements-apiphytocompositions therapeutic and prophylactic action with the use of economical biotechnology. They were used by patients as an additional food product in combination with evidence-based medicine protocols in the complex therapy of humans. The results of the study revealed their positive effect on the human body. Conclusions and prospects for further research. Developed food products – dietary supplements-apiphytocomposition can be used both for monotherapy and in combination with evidence-based medicine protocols in complex therapy of humans.

Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention.

This article continues our presentation of the Brazilian Psychiatric Association guidelines for the management of patients with suicidal behavior, with a focus on screening, intervention, postvention, prevention, and promotion. For the development of these guidelines, we conducted a systematic review of the MEDLINE (via PubMed), Cochrane Database of Systematic Reviews, Web of Science, and SciELO databases for research published from 1997 to 2020. Systematic reviews, clinical trials, and cohort/observational studies on screening, intervention, and prevention in suicidal behavior were included. This project involved 14 Brazilian psychiatry professionals and 1 psychologist selected by the Psychiatric Emergencies Committee of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. Publications were evaluated according to the 2011 Oxford Center for Evidence-Based Medicine (OCEBM) Levels of Evidence Classification. Eighty-five articles were reviewed (of 5,362 initially collected and 755 abstracts on the drug approach). Forms of screening, intervention, and prevention are presented. The intervention section presents evidence for psychotherapeutic and drug interventions. For the latter, it is important to remember that each medication is effective only for specific groups and should not replace treatment protocols. We maintain our recommendation for the use of universal screening plus intervention. Although the various studies differ in terms of the populations evaluated and several proposals are presented, there is already significant evidence for certain interventions. Suicidal behavior can be analyzed by evidence-based medicine protocols. Currently, the best strategy is to combine several techniques through the Safety Plan. Nevertheless, further research on the topic is needed to elucidate some approaches with particular potential for intervention and prevention.Systematic review registry number: CRD42020206517

Stratification of radiological test ordering: Its usefulness in reducing unnecessary tests with consequential reduction in costs

This study examines the effectiveness of an automated, stratified system of radiological test ordering, known as 'Traffic Lights', in reducing the number of unnecessary tests and their associated costs. The system involves stratification of radiological tests into three groups, denoted by red, amber and green colours. 'Red' tests must be authorized by a consultant. 'Amber' tests must be signed by a registrar or authorized by a consultant. 'Green' tests can be ordered directly by residents or interns. In the 4 months after the introduction of 'Traffic Lights', each radiological method showed a reduction in both the number of tests and their associated costs. The reduction was consistent across both medical and surgical groups. Analysis of data 20 months immediately after the introduction of 'Traffic Lights' also showed a consistent reduction in the total number of tests, suggesting that the changes are sustainable and unlikely to be due to seasonal variation. Combined with evidence-based medicine protocols, this stratified system of radiological test ordering should ensure the safety, quality and appropriateness of imaging tests and minimize overall patient radiation dose.

Major threats to childbirth in developing countries.

Biological, psychological or social elements may constitute a threat to childbirth. In developing countries, major threats to childbirth mainly caused by restricted health service budgets may be overcome by the introduction of appropriate screening tests, implementation of evidence-based medicine protocols, and a primary health-care approach to maternity services.