What is evidence-based medicine? | evidence based medicine คือ

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What is evidence-based medicine?

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นอกจากการดูบทความนี้แล้ว คุณยังสามารถดูข้อมูลที่เป็นประโยชน์อื่นๆ อีกมากมายที่เราให้ไว้ที่นี่: ดูเพิ่มเติม

Hear Dr. William Abdu, Medical Director of DartmouthHitchcock Medical Center’s Spine Center, talk about what evidencebased medicine is and how it is incorporated into the care he and his staff provide at the Spine Center. Appropriate surgical and medical spine care is dependent upon both contribution to medical literature as well as implementation of those proven techniques in clinical practice. The Spine Center team has demonstrated success with their patients based on their knowledge, adherence to proper patient education and shared decision making and by following a narrow list of symptoms as to who makes a good surgical candidate. Those patients who do not fit the criteria for surgery or who choose to manage their pain nonsurgically will benefit from the Spine Center’s experienced medical providers, therapists and the oneofakind Functional Restoration Program.
Learn more at: http://patients.dh.org/spine/

Pyramid of Evidence – Evidence based medicine (EBM)

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Fares Alahdab, MD
Research fellow and assistant professor of medicine at Mayo Clinic.
We have suggested to change the way we visualize the hierarchy of medical evidence to reflect a better understanding of the risk of bias in different study designs, grading the medical evidence/literature (GRADE Framework), and the use and application of systematic reviews and metaanalyses.
We published this article in the BMJ Journal of Evidence Based Medicine. It can be accessed here:
http://ebm.bmj.com/content/21/4/125
Still a year after its publication, this article was the most commonly viewed and accessed paper in this journal. We hope this helps promote this message to all EBM learners and teachers.

Explained | Why Women Are Paid Less | FULL EPISODE | Netflix

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In partnership with Vox Media Studios and Vox, this enlightening explainer series will take viewers deep inside a wide range of culturally relevant topics, questions, and ideas. Each episode will explore current events and social trends pulled from the zeitgeist, touching topics across politics, science, history and pop culture featuring interviews with some of the most authoritative experts in their respective fields.
In this episode: Hillary Clinton and AnneMarie Slaughter discuss the cultural norms at the center of the worldwide gender pay gap, including the \”motherhood penalty.\”
US Rating: TVMA. This show is designed for for mature audiences only.
For more information and educational resources, please visit:
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Netflix is the world’s leading streaming entertainment service with over 167 million paid memberships in over 190 countries enjoying TV series, documentaries and feature films across a wide variety of genres and languages. Members can watch as much as they want, anytime, anywhere, on any internetconnected screen. Members can play, pause and resume watching, all without commercials or commitments.
Explained | Why Women Are Paid Less | FULL EPISODE | Netflix
https://youtube.com/Netflix

Introduction to Evidence Based Practice

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This is a short introduction to evidencebased practice. Understand that evidencebased practice depends on evidence, expertise, and the patient’s values. Learn the steps of evidencebased practice.
This video was originally created for NURS 3330, so it has a few references specific to nursing and this particular course.\r
\r
Table of Contents: \r
\r
00:00 EBP Intro\r
00:33 What is EBP? \r
01:05 EBP Why Bother?\r
01:25 EBP Why Bother?\r
01:41 EBP 6 Steps\r
02:32 Why a Librarian?\r
02:53 Step 1: Asking the Question\r
03:27 Step 2: Searching\r
03:40 Step 3: Appraisal\r
03:54 Slide 10
Author of this video: Molly Montgomery

New evidence

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Error, So sorry, of course the liver is on the right and the spleen on the left, dont know how I managed to get that worng.
Thrombocytopenia and splenic platelet directed immune responses after intravenous ChAdOx1 nCov19 administration
https://www.biorxiv.org/content/10.1101/2021.06.29.450356v1.abstract?%3Fcollection=

Recently a rare and novel complication of SARSCoV2 targeted adenovirus vaccines has emerged:
thrombosis with thrombocytopenia syndrome (TTS)
Low platelets, clot formation at unusual sites and plateletactivating PF4polyanion antibodies (reminiscent of heparininduced thrombocytopenia).
In vitro and in vivo models
Platelettargeted autoimmunity
We show that intravenous but not intramuscular injection of ChAdOx1 nCov19 triggers plateletadenovirus aggregate formation and platelet activation.
After intravenous injection, these aggregates are phagocytosed by macrophages in the spleen
This is followed by a pronounced Bcell response with the emergence of circulating antibodies binding to platelets.
Our work contributes to the understanding of TTS and highlights accidental intravenous injection as potential mechanism for postvaccination TTS.
Hence, safe intramuscular injection, with aspiration prior to injection, could be a potential preventive measure when administering adenovirusbased vaccines.
Consistent results with mice and human platelets
Vaccines are routinely administered intramuscularly (i.m.) and trigger immune responses mainly in the draining lymph nodes
Based on our finding that adenoviral vaccine binds to blood platelets, we hypothesized that accidental intravenous injection of adenoviral vaccine might lead to plateletadenovirus aggregate formation with platelet activation
The decline in platelet count was dosedependent and correlated directly with adenoviruspositive platelets circulating in the blood one hour after i.v. injection
Intravenous but not i.m. injection of ChAdOx1 nCov19 resulted in a strong increase in plateletadenovirus aggregates
Authors
Medizinische Klinik und Poliklinik I University Hospital LudwigMaximilian University Munich, Germany
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany
Medizinische Klinik und Poliklinik III University Hospital LudwigMaximilian University Munich, Germany
Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific, Institute, Milan, Italy.

Previous peer reviewed evidence
Intravenous administration of recombinant adenoviruses causes thrombocytopenia, anemia and erythroblastosis in rabbits, (Journal of Gene Medicine, 1999)
https://pubmed.ncbi.nlm.nih.gov/10738553/
The systemic administration of a therapeutic dose of 5 x 10(11) infectious particles/kg (infusion time 20 min) led to an average reduction of 8090% in the platelet count within 48 h.
Adenovirusinduced thrombocytopenia: the role of von Willebrand factor and Pselectin in mediating accelerated platelet clearance, (Blood, 2007)
https://pubmed.ncbi.nlm.nih.gov/17148587/
Thrombocytopenia has been consistently reported following the administration of adenoviral gene transfer vectors.
The virus activates platelets and induces plateletleukocyte aggregate formation.
Polyethylene glycol modification of adenovirus reduces platelet activation, endothelial cell activation, and thrombocytopenia, (Human gene therapy, 2007)
https://pubmed.ncbi.nlm.nih.gov/17767399/
Thrombocytopenia is one of the complications for in vivo administration of adenovirus serotype 5 (Ad5) vectors after intravenous injection.
Plateletadenovirus vs. inert particles interaction: effect on aggregation and the role of platelet membrane receptors, (Platelets, 2013)
https://pubmed.ncbi.nlm.nih.gov/22812520/
Virus mediated gene therapy applications are still challenged by the resultant thrombocytopenia and the mechanism(s) of plateletforeign particles interaction remains unclear.
Pseudotyping Serotype 5 Adenovirus with the Fiber from Other Serotypes Uncovers a Key Role of the Fiber Protein in Adenovirus 5Induced Thrombocytopenia, (Human gene therapy, 2016)
https://pubmed.ncbi.nlm.nih.gov/26757054/

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