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Complementary Medicine Research 2021This article maintains that via the current form of evidence-based medicine, scientism (a pseudo-religious belief in science that is itself not scientific) has been... (Review)
Review
This article maintains that via the current form of evidence-based medicine, scientism (a pseudo-religious belief in science that is itself not scientific) has been allowed to encroach into medicine. By setting out the philosophical limits of what it is science can do, the effects of this encroachment are discussed in terms of upsetting the balance between the necessarily conflicting art AND science of medicine. In this context, one effect of the Covid-19 pandemic might be to act as a timely reminder - as if it was needed - of the importance of the Hippocratic Oath, which is and always has been the soul of medicine.
Topics: COVID-19; Clinical Reasoning; England; Evidence-Based Medicine; Forecasting; Hippocratic Oath; Humans; Science
PubMed: 32998145
DOI: 10.1159/000510229 -
Complementary Medicine Research 2018
Topics: Economics, Medical; Education, Medical; Humans; Medicine
PubMed: 30114696
DOI: 10.1159/000492482 -
International Journal of Pharmaceutics Mar 2022The total number of paediatric formulations available only account for a small proportion of the full therapeutic plethora required to effectively treat paediatrics and,... (Review)
Review
The total number of paediatric formulations available only account for a small proportion of the full therapeutic plethora required to effectively treat paediatrics and, therefore, the availability of high quality medicines designed specifically for children remains an ongoing challenge. Currently, the World Health Organisation (WHO) report that around 50% of medication issued for long-term conditions are not taken as advised, whilst it has also been established that, in general practice, around one tenth of medicines prescribed for children are either off-label or unlicensed. Such off-label and unlicensed use is owing to the considerable anatomical and physiological differences observed between paediatric subsets. Identifying such differences, is essential for better informing paediatric drug development and assisting regulatory reviews, whilst ensuring safe and effective therapeutic concentrations of pharmacological substances. Points covered: The review discusses factors affecting the safety, toxicity and efficacy of paediatric drug delivery systems. The research highlights features of the gastrointestinal tract and reports anatomical and physiological differences between paediatrics and adults. Additionally, differences observed in paediatric pharmacokinetic profiles (absorption, distribution, metabolism and elimination) due to physiological differences are also discussed. Furthermore, this review considers the advantages and limitations of current paediatric specific dosage forms available and assesses the acceptability of innovative small flexible solid oral dosage forms. Lastly, this review highlights factors affecting paediatric medicine adherence and acceptability and discusses the techniques available to overcome barriers associated with non-adherence.
Topics: Adult; Child; Dosage Forms; Humans; Off-Label Use; Pediatrics; Pharmaceutical Preparations
PubMed: 35092832
DOI: 10.1016/j.ijpharm.2022.121501 -
Digestive Diseases (Basel, Switzerland) 2017Phytotherapy is an important therapeutic option in functional gastrointestinal diseases (FGID). It has a large tradition, with different approaches in different regions... (Review)
Review
BACKGROUND
Phytotherapy is an important therapeutic option in functional gastrointestinal diseases (FGID). It has a large tradition, with different approaches in different regions of the world, some of which have made their way into modern evidence-based medicine (EBM).
SUMMARY
Taking into account the number of herbs in use, and also the cumulated scientific evidence on them, FGID are possibly the most important indication in phytotherapy. This does not only apply for European phytotherapy, but also for other regions, such as Asia. Within European phytotherapy, herbs active in FGID are usually classified according to their main active constituents and their activities. Typically, the herbs used in FGID are grouped into amara, aromatica, amara aromatica combining both properties, herbs stimulating gastric secretion, herbs containing spasmolytic and carminative essential oils or spasmolytic alkaloids, mucilaginosa soothing the mucosa, and flavonoid containing drugs with anti-inflammatory properties. In phytotherapy, different plants are frequently combined to maximize effectiveness and specificity of action. Very potent combination products can be developed when the mechanisms of action of the combination partners are complementary. This approach can be demonstrated by the example of STW 5. For this herbal combination product, therapeutic efficacy in FGID has been clinically proven according to the highest standards of EBM. This example also underlines that modern rational phytotherapy is definitely part of modern EBM. Key Messages: FGID is one of the most important indications in phytotherapy and rationally combined herbal preparations are established evidence-based therapeutic options.
Topics: Evidence-Based Medicine; Gastrointestinal Diseases; Humans; Phytotherapy; Plant Extracts
PubMed: 29421793
DOI: 10.1159/000485489 -
African Journal of Primary Health Care... Mar 2020In the context of addressing the pressing health needs for the global population, the World Health Organization has repeatedly called for universal health coverage (UHC)... (Review)
Review
In the context of addressing the pressing health needs for the global population, the World Health Organization has repeatedly called for universal health coverage (UHC) to be prioritised by its member countries. This is to be achieved through a high-quality primary health care (PHC) approach that provides comprehensive and integrated generalist care as close to where people live as well as links the clinical care to health promotion and disease prevention. In this paper, we argue for the introduction of family medicines as a critical player in the healthcare system of Tanzania to strengthen the strategies towards UHC. The paper reviews how PHC is understood, the context of family medicine in sub-Saharan Africa and makes a case for how family medicine can assist in addressing the current burden of disease in Tanzania.
Topics: Family Practice; Health Care Reform; Humans; Tanzania; Universal Health Insurance
PubMed: 32242426
DOI: 10.4102/phcfm.v12i1.2129 -
Revista Da Associacao Medica Brasileira... Mar 2019
Topics: Brazil; Health Knowledge, Attitudes, Practice; Humans; Phytotherapy; Plants, Medicinal; Public Health
PubMed: 30994823
DOI: 10.1590/1806-9282.65.3.292 -
British Journal of Hospital Medicine... Nov 2022Medicine research and development has been instrumental in improving outcomes for countless individuals, but women, especially pregnant women, have been left behind....
Medicine research and development has been instrumental in improving outcomes for countless individuals, but women, especially pregnant women, have been left behind. Disadvantaged during pregnancy as a result of apprehension over drug use for new or existing conditions, women face worse outcomes for under- or untreated disease. Solving this problem will require input from regulators, the pharmaceutical industry and clinicians.
Topics: Pregnancy; Child; Female; Humans; Fear; Drug Industry; Medicine
PubMed: 36454072
DOI: 10.12968/hmed.2022.0312 -
Lakartidningen Apr 2023Overdiagnosis and overtreatment receive increasing attention. More than 20 percent of health expenditure is without patient benefit, so-called low-value care. Several...
Overdiagnosis and overtreatment receive increasing attention. More than 20 percent of health expenditure is without patient benefit, so-called low-value care. Several national and international initiatives have been launched to minimize low-value care. Arguably, the most widely spread initiative is Choosing Wisely. First launched by the American Board of Internal Medicine in 2012, this campaign has spread to more than 20 countries. The Swedish Society of Medicine has identified low-value care as a significant problem in Swedish health care and has established a working group to investigate if and how a campaign based on Choosing Wisely would be feasible in Sweden. Here, the working group reports on the history of Choosing Wisely, identifies potential challenges for deimplementation generally and in the Swedish context specifically.
Topics: Humans; United States; Sweden; Internal Medicine; Delivery of Health Care
PubMed: 37057979
DOI: No ID Found -
AMA Journal of Ethics Mar 2022Medical education is limited to the biomedical model, omitting critical discourse about racism, the harm it causes minoritized patients, and medicine's foundation and...
Medical education is limited to the biomedical model, omitting critical discourse about racism, the harm it causes minoritized patients, and medicine's foundation and complicity in perpetuating racism. Against a backdrop of historical resistance from medical education leadership, medical students' advocacy for antiracism in medicine continues. This article highlights a medical student-led antiracist curricular effort that moves beyond a biomedical model and uses abolition as the guiding framework in the creation process, the content itself, and iterative reflection through further study and dissemination.
Topics: Education, Medical; Humans; Leadership; Medicine; Racism; Students, Medical
PubMed: 35325520
DOI: 10.1001/amajethics.2022.194 -
Archives of Iranian Medicine May 2021Depression is a chronic and debilitating psychiatric disorder that affects 300 million people worldwide. Pharmacotherapy is one of the treatments. Due to delay in... (Review)
Review
Depression is a chronic and debilitating psychiatric disorder that affects 300 million people worldwide. Pharmacotherapy is one of the treatments. Due to delay in initiating treatment efficacy and the incomplete response to mono-drug therapy in one-third of patients, new approaches need to be considered. One of the ways to overcome this resistance to treatment and to enhance standard medical practice is to add complementary medicines. We aimed to document research progress from studies on integrative medicine for the treatment of depression. Review of PubMed and Scopus databases on the topic and a personal collection of the relevant publications are the sources for this study. Some of the nutraceuticals and complementary medicines in the treatment of depression will be reviewed. Supplements discussed in this review include S-adenosyl-methionine (SAMe), (Saffron), carnosine, theanine, palmitoylethanolamide (PEA), tryptophan and 5-hydroxytryptophan (5-HTP), gemfibrozil, curcumin (the main active ingredient in turmeric), (St John's wort), (Lavender), and . Despite evidence in favor of the antidepressant effect of several supplements, their efficacy and tolerability should be evaluated and validated by further high-quality studies.
Topics: Antidepressive Agents; Complementary Therapies; Depression; Humans; Hypericum; Integrative Medicine; Phytotherapy
PubMed: 34196207
DOI: 10.34172/aim.2021.59