Evidence based medicine became a reality during the end of 20 century, but its development makes visible a number of weaknesses of the scientific (evidence) base of medicine
Linear increase in the best-practice (maximal among countries) life expectancy, known as the Oeppen– Vaupel line, is the most demonstrative image of longevity progress. This study is devoted to the analysis of trends in best-practice life expectancy across cohorts born in 1870 to 1950. Other than the conventional period life expectancy, cohort life expectancy measures the lifetime of real individuals from the population under consideration. Since mortality is mostly decreasing with time, period life expectancy in a given year is usually lower than cohort life expectancy for people born in the same year. The corresponding gap between period and cohort life expectancies increases with time. Our analysis is based on data for 24 developed countries from the Human Mortality Database for the period 1870 to 2008. To estimate life expectancy for non-extinct cohorts, we apply the Lee–Carter model to extrapolate mortality rates until the year 2050. The annual increase in the best-practice cohort life expectancy across cohorts born in 1870 to 1950 is 0,43 year, while the annual increment in the period life expectancy across the same range of years is equal to 0,28 year. The best-practice cohort life expectancy has increased from 53,7 years in 1870 to 83,8 years in 1950. During this time the gap between period and cohort life expectancies has increased from 1,2 to 10,3 years. Cohorts born in 1920 to 1950 will live longer than one can expect by looking at respective period mortality patterns. For these cohorts, the longest part of their additionally gained lifetime will be spent at ages 65 and older. This substantially changes the distribution of human lifetime among different stages of the life cycle.
This article presents results of the study, based on interviews with classical homoeopaths. We focus on the apparent tension between the statements of classical homeopathy and practices. On the one hand, classical homeopathy declares a gap with biomedicine, but on the other — the status of this break is not confirmed by their practice. This paradox problematize with the practice theory proved that the practice of classical homeopathy includes a biomedical preposition as tacit knowledge (M. Polany). On the way to this conclusion we considered conceptual question of relations of inconsistent practices and their transmission. Accessing G. Ryle’s critique of mentalism and ideas of practice theorists we justify vivid character of practices and tacit knowledge as visible, but does not noticed; thus we overcome S. Turner’s skepticism about the reality of practices as a collective phenomenon, capable of transmission. In contrast to the Turner’s causal interpretation of practice theory, the relationship between biomedical assumptions and homeopathic practice is proposed as the ratio of figure and ground. This conception is refined with the help of L. Wittgenstein’s idea of change aspect, in which homeopathy and biomedicine are not acting different practices but particular aspects of one indivisible medical practice. As a criterion of visibility biomedical prepositions called the fact of classical homeopathy emphasizing the differences and contradictions of homeopathy and biomedicine, as well as their ability to transfer (change of aspect) between concepts of the two systems. From this point of view, classical homeopathy statements should not comply with the specific targets of a particular medical practice in which they engage, rather then the purposes of identification and professionalization. Thus the tacit knowledge paradox is achieved by separating professionalized strategies from a purely medical ones.
The paper discusses the techniques which are currently implemented for vaccine production based on virus-like particles (VLPs). The factors which determine the characteristics of VLP monomers assembly are provided in detail. Analysis of the literature demonstrates that the development of the techniques of VLP production and immobilization of target antigens on their surface have led to the development of universal platforms which make it possible for virtually any known antigen to be exposed on the particle surface in a highly concentrated form. As a result, the focus of attention has shifted from the approaches to VLP production to the development of a precise interface between the organism’s immune system and the peptides inducing a strong immune response to pathogens or the organism’s own pathological cells. Immunome-specified techniques for vaccine design and the prospects of immunoprophylaxis are discussed. Certain examples of vaccines against viral diseases and cancers are considered.
Analysis of results of epidemiological BOLERO study showed that 2/3 of men with uncontrolled arterial hypertension noted problems in sexual life. Severity of problems in this sphere of life of men correlated positively with age, as well as with presence of difficulties at work, increased fatigability, impossibility to be involved in favorite activity (hobby), disturbances of nocturnal sleep (as assessed by GQLI questionnaire). As a result of 8 weeks therapy which included indapamide retard number of patients noting substantial influence of sexual problems on their habitual way of life (CQLI score >3) decreased almost 2 times (from 25 to 13%, p<0,001). At least 1 point decrease in evaluation of importance of such problems occurred in 33% of cases, 63% of patients did not change their score. An increase of GQLI score was noted in 4% of cases. Multifactorial analysis allowed to reveal that restoration of sexual function went parallel with improvement of quality of life related to recovery of psychosocial relationships and augmentation of physical activity. Moreover it was established that adequate lowering of arterial pressure in men during use of indapamide retard decreased risk of worsening of their sexual function.
The paper suggest that learned helplessness, as a special case of the Pavlovian conditioning, may be accompanied by negative implicit attitudes towards Monday and expectations for Friday as a means to get rid of a «punishment», which may be a factor in the development of emotional exhaustion—a key manifestation of the burnout syndrome
50% patients with chronic disease shows unintentional and intentional medication non-adherence. Medication non-adherence causes 4 to 10% of preventable healthcare losses. SMS reminders are associated with significant improvement in adherence rates. The current paper tests whether the question-behavior effect (QBE) could improve SMS reminders effectiveness. Preliminary RCT (N=40) shows positive, but not significant effect of QBE/SMS combination on medication adherence rates (ASD=0.249 (95% C. I. -0.061 – 0.560)), which corresponds to the predicted effect size (ASD=0.166 (95% C. I. 0.044 – 0.276)). Additional research is required for confirmation of QBE/SMS combination effectiveness.
The article describes the experience of integration of basic principles of corporate management into administration of public hospital.
The results of microwave influence aimed at the temperature rise in local area in multilayered biological tissues are given. the experimental results of temperature distribution in multilayered biological tissue are presented at the electromagnetic field frequency of 2450MHz. The model and analytic calculations for the temperature distribution inside the biological tissue are presented. The calculation results for the temperature distribution in multilayered biological tissues are given.
The hypoxic response critically depends on the rapid stabilization of the Hypoxia-Inducible Factor (HIF). In normoxic conditions, HIF-prolyl hydroxylases mark α-subunits of HIF for degradation, while the hypoxia results in stabilization of HIF-α. Oxyquinoline derivatives suppress the activity of HIF-prolyl hydroxylases, leading to the stabilization of HIF. Here we show that the 24 hour incubation of the trophoblast model choriocarcinoma cells BeWo b30 line with the oxyquinoline derivative leads to a decrease in the transepithelial electrical resistance (TEER) of the cell monolayer, while the permeability of the monolayer for the FITC-dextran (70 kDa) remains unchanged. These observations indicate that the overall barrier function remain preserved, while the structure of intercellular tight junctions may undergo remodeling. Using Affymetrix Human Transcriptome Array 2.0, we show that the treatment with oxyquinoline derivative lead to a decrease in the expression of claudines 6 and 7 (CLDN6, CLDN7), occludin (OCLN), contact adhesion molecule 3 (JAM3) and angiotomin-like protein 1 (AMOTL1), which possibly explain the observed changes in TEER.