#1
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Ñòîèò ëè ïðèìåíÿòü ÁÀÄ?
Áàóøêå 63 ãîäà. ïîñëåäíåå âðåìÿ îíà ñòàëà æàëîâàòüñÿíà ðàññåÿííîñòü, ïåðèîè÷åñêèå ãîëîâîêðóæåíèÿ. Ìû ñ íåé ñõîäèëè ê íåâðîëîãó, ïðîâåëè âñå íåîáõîäèìûå îáñëåäîâàíèÿ.  èòîãå âðà÷ ñêàççàë, ÷òî íè÷åãî ñòðàøíîãî íåò, ñîñóäû ñîîòâåòñòâóþò âîçðàñòó. À ðàññåÿííîñòü è ãîëîâîêðóæåíèÿ ñâÿçàíû èìåííî ñ îñëàáëåíèåì ñòåíîê ñîñóäîâ, è õîðîøî áû èõ ïîääåðæàòü.È â êà÷åñòâå ïðîôèëàêòèêè ïðåêîìåíäîâàë ïðèíèìàòü áàä Öåíòîìàêñ. Îí ñîñòîèò èç Ãèíêî áèëîáà.öåíòåëëû àçèàòñêîé, âèíîãðàäíîé êîñòî÷êè äèèðîêâåðö.... (î÷åíü ñëîæíîê íàçâàíèå). Âîò òåïåðü ñîìíåâàþñü,ñòîèò ëè ïðèíèìàòü åãî áàóøêå? Êàêîâî ìíåíèå âðà÷åé?
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#2
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Íå ñòîèò.
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#3
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Ïî÷åìó?Âåäü ðå÷ü èäåò î ïðîôèëàêòèêå, à íå î ëå÷åíèè.
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#4
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"Ìû ñ íåé ñõîäèëè ê íåâðîëîãó, ïðîâåëè âñå íåîáõîäèìûå îáñëåäîâàíèÿ."
ÊÀÊÈÅ? |
#5
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Ðå÷ü èäåò î âûáðàñûâàíèè äåíåã. Ñóùåñòâóþò äîêàçàííûå ìåòîäû ñåðäå÷íî-ñîñóäèñòîé ïðîôèëàêòèêè - ïðèåì àñïèðèíà, ñíèæåíèå óðîâíÿ õîëåñòåðèíà, íîðìàëèçàöèÿ äàâëåíèÿ è äð. Çà÷åì îòäàâàòü äåíüãè íåïîíÿòíî êîìó, êîãäà ìîæíî èäòè ïî ïóòè, ïî êîòîðîìó èäåò âåñü ìèð, òîò â êîòîðîì ïðîäîëæèòåëüíîñòü æèçíè íà 20 ëåò áîëüøå...
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#6
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Öèòàòà:
Òåì íå ìåíåå, òîò æå Ãèíêãî áèëîáà î÷åíü øèðîêî ïðèìåíÿåòñÿ â îáùåìåäèöèíñêîé ïðàêòèêå "âî âñåì ñâîáîäíîì ìèðå", èìåííî â âèäó òîãî ñóáúåêòèâíîãî óëó÷øåíèÿ êîòîðîå ïîëó÷àåò ïàöèåíò. Äðóãîå äåëî, ÷òî íå ñòîèò ïðèìåíÿòü åãî â íåñòàíäàðòèçèðîâàííûõ áèîäîáàâêàõ. |
#7
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Óâàæàåìûé ñïåöèàëèñò "ïî âñåìó ìèðó" òîâ Âÿ÷åñëàâ , ñïðàâäåëèâîñòè ðàäè Âàì ñäåäîâàëî åùå îòìåòèòü , ÷òî ìàðèõóàíà åùå áîëüøå óëó÷øàåò æèçíü, à èññëåäîâàíèÿ íàäî åùå è ïîíÿòü - ìàëî ïðî÷åñòü ðåçóëüòàòû
Âîîáùå åñëè íåêóäà äåòü ãèíêî áèëîáó, òàê íå çàïðåùàòü æå å¸ áîëüíûì âî âðåìÿ êðèçèñà? È ïðîèçâîäñòâî íàëàæåíî, è òåòå Ìóñå ïåðåä ïàðàëèêîì óæàñòü êàê õîðîøî áûëî,,, È âåëåíî îòå÷åñòâåííîãî ïðîèçâîäèòåëÿ ïîêîðìèòü ..
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Ã.À. Ìåëüíè÷åíêî |
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#8
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Öèòàòà:
Ñîãëàñåí, ÷òî ïðèåì ÃÁ äëÿ ïðîôèëàêòèêè íå îïðàâäàí - íå äîêàçàíî. Íî âñåãäà ïîìíèòå, ÷òî âû íå ãàéêè çàêðó÷èâàåòå, à ëå÷èòå áîëüíîãî, â òîì ÷èñëå è èñïîëüçóÿ ïëàöåáî-ýôôåêò. Èíà÷å áóäåò: ÿ ëå÷ó áîëüíîãî ïî 13 ïàðàãðàôó, íî åìó íå ëó÷øå. íå âàæíî ãëàâíîå ïî èíñòðóêöèè)). |
#9
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Öèòàòà:
PS. Àæ ïåðåäåðíóëî îò îòâðàùåíèÿ.
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Lead, follow, or get out of the way. — Thomas Paine |
#10
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Öèòàòà:
Òîëüêî ÷òîáû âñ¸ ÷åñòíî, à íå òàê, ÷òî ïîëå÷èì 10 áîëüíûõ, íàïèøåì, ÷òî 50, ãðóïïó êîíòðîëÿ âûñîñåì èç... ïàëüöà, ïîñ÷èòàåì â Ýêñåëå ïî Ñòüþäåíòó, ð, êàê ïîëàãàåòñÿ, íàïèøåì <0,05 .. èçäàäèì ìåòîäè÷êó "íàøåé êàôåäðû" ñ ãðèôîì ÓÌÎ (íå ïóòàòü ñ óìîì). |
#11
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Öèòàòà:
Òîãäà óæå ïîðà è ïð. ïîíèìàòü , è äðóãèì ñîâåòû äàâàòü êàê ëå÷èòü - íå âñå æå , êàê Âû, óæå 5 ëåò çàíèìàþòñÿ.. Ñòðàíà ñîâåòîâ îò ïðîèçâîäèòåëåé ïëàöåáî ..
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Ã.À. Ìåëüíè÷åíêî |
#12
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Îòâå÷ó âñåì - è ãëóáîêîóâàæàåìûì êîëëåãàì è ìàëîîáðàçîâàííûì ýìîöèîíàëüíûì âûñêî÷êàì.
Íèêòî íå îòìåíÿë îáñëåäîâàíèå "áàáóøêè" - íå â òîì âîïðîñ, îáñëåäîâàòü íóæíî - è ëèïèäîãðàììó è äîïëåðîãðàôèþ ÁÖÀ (èñêëþ÷åíèå ñòåíîçîâ è íåñòàáèëüíûõ áëÿøåê), ïðè ïîêàçàíèÿõ ìîæíî è ÌÐÒ ñäåëàòü, ÿ óæå íå ãîâîðþ î ãëþêîçå, áèîõèìèè è îáùåêëèíè÷åñêèõ àíàëèçàõ. Äëÿ ðåøåíèÿ, âîïðîñà î äåìåíöèè - òåñòû íà êîãíèòèâíûå ôóíêöèè, îöåíèòü ïñèõîýìîöèîíàëüíîå ñîñòîÿíèå, ïðè íåîáõîäèìîñòè ïðîâåñòè êàðäèîëîãè÷åñêîå îáñëåäîâàíèå (ñóòî÷íîå ìîíèòîðèðîâàíèå ÀÄ è ÝÊÃ). È òîëüêî ïîñëå ýòîãî çàíèìàòüñÿ "ÏÐÎÔÈËÀÊÒÈÊÎÉ". Õî÷ó âàì íàïîìíèòü, ÷òî ñòàòèíû íàçíà÷àþòñÿ ïðè ñîîòâåòñòâóþùèõ ïîêàçàòåëÿõ ëèïèäîãðàììû, à àñïèðèí - äëÿ ÂÒÎÐÈ×ÍÎÉ ïðîôèëàêòèêè èíñóëüòîâ (â íåâðîëîãèè, â êàðäèîëîãèè äðóãîé ïîäõîä) - à íå âñåì ïîäðÿä. Ïðè íàëè÷èè âåñòèáóëÿðíûõ ãîëîâîêðóæåíèé ïîêàçàí, êàê èçâåñòíî áåòàñåðê, à ïðè íàëè÷èè äåìåíöèè - ìíåìàíòèí, ðåìèíèë è ïð. Ýòî ÿ ñîîáùàþ äëÿ íàøèõ ìàëîîáðàçîâàííûõ äðóçåé, êîòîðûå íå âîøëè â ñóòü âîïðîñà, à ñòàâèòü "íåîäîáðÿëêè" íàó÷èëèñü (áëàãî áóìàãà - ò.å. ôîðóì âñå ñòåðïÿò). ÂÑÅ ÝÒÎ ÍÓÆÍÎ, íèêòî íå îòðèöàåò. Êîíêðåòíî, ïî ïîâîäó ïëàöåáî-ýôôåêòà - íàçâàíèå ïîäîáðàíî íåâåðíî, âîò è ââîäèò â çàáëóæäåíèå - à åãî èñïîëüçîâàíèå â ïðàêòèêå âðà÷à - îäíà èç âàæíûõ ñîñòàâëÿþùèõ åæåäíåâíîé ïðàêòèêè, à íå îòâëå÷åííûõ "äîêàçàòåëüíûõ" ðàññóæäåíèé. Î ÷åì ìíîæåñòâî ñòàòåé, â òîì æå Ëàíöåòå. Ñëåäóþùåå, Ãèíêãî áèëîáà íå åñòü ïëàöåáî - ðÿäîì õîðîøî ïðîâåäåííûõ äâîéíûõ ïë.-êîíòðîëèðóåìûõ èññëåäîâàíèé äîêàçàíà åãî ýôôåêòèâíîñòü, â ÷àñòíîñòè â óëó÷øåíèè êîãíèòèâíûõ è ìíåñòè÷åñêèõ ôóíêöèé (òà ñàìàÿ ðàñåÿííîñòü ó áàáóøêè), à âîò â êà÷åñòâå ïðîôèëàêòèêè èíñóëüòîâ, òàêæå ïðîâîäèëèñü èññëåäîâàíèÿ - ÍÎ, ðåçóëüòàòû ïðîòèâîðå÷èâûå, ïîýòîìó ïîêà âñå èäåò íà óñìîòðåíèå ëå÷àùåãî âðà÷à. (ìû èññëåäîâàíèåì ãèíêãî áèëîáà íå çàíèìàëèñü). Ïîýòîìó, ãîñïîäà, ýìîöèè ýòî îäíî, à ôàêòû è ïðàâèëüíîå ïîíèìàíèå èçëîæåííîãî - íå÷òî èíîå. Ïî ïîâîäó ìåòîäè÷åê ÓÌÎ - êòî áåç ãðåõà? Ñïàñèáî. |
#13
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Âñå - òàêè ýòî íåâåðîÿòíî çàáàâíî - áàíàëüíîñòè â èñïîëíåíèè äåòñêè - íàèâíîì ñ óáåæäåíèåì îá îòêðûòèè âåëèêîé èñòèíû..
Íó äàëñÿ âàì çëîïîëó÷íûé ãèíêî èëè çàõîòåëîñü ïîóìíè÷àòü ïðî ñòàòèíû - ðàññêàçûâàëè áû äåòÿì â äåòñêîì ñàäó , èëè æåíå - íî âåäü ñìåøíî òàëäû÷èòü íå÷òî âî èìÿ íåçíàìî ÷åãî Âû ÷òî ñêàçàòü -òî õîòèòå, Ñëàâèê ? ×òî íà Âàñ , íàçíà÷àþùåãî ÌÐÒ âî èìÿ ñïàñåíèÿ îò äåìåíöèè ÷åëîâå÷åñòâà , âñå îñòàëüíûå äîëæíû ìîëèòñÿ åæåäíåâíî è åæå÷àñíî? Ðàç óæ Âû öåëûõ 5 ëåò íå÷òî èçó÷àåòå? Âàì âåäü íå ðå÷è òîëêàòü , âàì ó÷èòüñÿ íàäî - õîòü ñ áåòàñåðêîì çëîïîëó÷íûì.. Ïðàâî ñëîâî, íàèâíûé Âû ïàðåíü, íà÷íèòå ÷èòàòü , à òî Âû òóò ñîâåòû âñåëåíñêîãî ìàñøòàáà äàâàòü íà÷èíàåòå ( ÷òî -òî êàêàÿ-òî çíàêîìàÿ ôðàçà âåðòèòñÿ íà óìå, íå ïîäñêàæåòå ? ) Âû ÷òî-òî õîòèòå ñêàçàòü âàæíîå è íóæíîå, íî êàê-òî ëîìèòåñü â îòêðûòóþ äâåðü ñ áàíàëüíûìè êðèêàìè íåïîíÿòíî ïî÷åìó
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Ã.À. Ìåëüíè÷åíêî |
#14
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Î÷åíü ïðèÿòíî ïîçíàêîìèòñÿ - à ÿ Ìåëüíè÷åíîê Ãàëèíà Àôàíàñüåâíà
Êîãäà ÿ ðàññêàçûâàþ î òîì èëè èíîì âàðèàíòå ëå÷åíèÿ èëè î äèàãíîñòèêå êîëëåãàì, ÿ îáû÷íî ñòðåìëþñü èñïîëüçîâàòü íå òîëüêî ñâîé îïûò èëè ñâîè ëè÷íûå êà÷åñâòà ( âîò Âû î ñåáå òàê ÿðêî ðàññêàçëàè ) , íî èñòî÷íèêè âûñîêãî óðîâíÿ äîêàçàòåëüíîñòè Âû, êàæåñòÿ , êîëëåãà, ñî ñâîéñòâåííûì Ïèòåðó èçÿùåñòâîì ðàçáèðàëè ñîâè ëè÷íûå êà÷åñòâà ? Ìíå êàæåòñÿ, êóäà ëþáîïûòå ïîãîâîðèüò î êîêðàíîâñêîé áàçå äàííûõ ï ëþáèììó Âàìè ðàñòåíèþ Cochrane Database Syst Rev. 2009 Jan 21;(1):CD003120. Links Ginkgo biloba for cognitive impairment and dementia. Birks J, Grimley Evans J. Centre for Statistics in Medicine, University of Oxford, Wolfson College, Linton Road, Oxford, UK, OX2 6UD. BACKGROUND: Extracts of the leaves of the maidenhair tree, Ginkgo biloba, have long been used in China as a traditional medicine for various disorders of health. A standardized extract is widely prescribed for the treatment of a range of conditions including memory and concentration problems, confusion, depression, anxiety, dizziness, tinnitus and headache. The mechanisms of action are thought to reflect the action of several components of the extract and include increasing blood supply by dilating blood vessels, reducing blood viscosity, modification of neurotransmitter systems, and reducing the density of oxygen free radicals. OBJECTIVES: To assess the efficacy and safety of Ginkgo biloba for dementia or cognitive decline. SEARCH STRATEGY: The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 20 September 2007 using the terms: ginkgo*, tanakan, EGB-761, EGB761, "EGB 761" and gingko*. The CDCIG Specialized Register contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trials databases and grey literature sources. SELECTION CRITERIA: Randomized, double-blind studies, in which extracts of Ginkgo biloba at any strength and over any period were compared with placebo for their effects on people with acquired cognitive impairment, including dementia, of any degree of severity. DATA COLLECTION AND ANALYSIS: Data were extracted from the published reports of the included studies, pooled where appropriate and the treatment effects or the risks and benefits estimated. MAIN RESULTS: 36 trials were included but most were small and of duration less than three months. Nine trials were of six months duration (2016 patients). These longer trials were the more recent trials and generally were of adequate size, and conducted to a reasonable standard. Most trials tested the same standardised preparation of Ginkgo biloba, EGb 761, at different doses, which are classified as high or low. The results from the more recent trials showed inconsistent results for cognition, activities of daily living, mood, depression and carer burden. Of the four most recent trials to report results three found no difference between Ginkgo biloba and placebo, and one found very large treatment effects in favour of Ginkgo biloba.There are no significant differences between Ginkgo biloba and placebo in the proportion of participants experiencing adverse events.A subgroup analysis including only patients diagnosed with Alzhiemer's disease (925 patients from nine trials) also showed no consistent pattern of any benefit associated with Ginkgo biloba. AUTHORS' CONCLUSIONS: Ginkgo biloba appears to be safe in use with no excess side effects compared with placebo. Many of the early trials used unsatisfactory methods, were small, and publication bias cannot be excluded. The evidence that Ginkgo biloba has predictable and clinically significant benefit for people with dementia or cognitive impairment is inconsistent and unreliable. ßóáåäèòåëüíî ïðîøó ìäåðàòîðà îñòàâèòü òåêñò êîëëåãè áåç èñêàæåíèé - ìíå î÷åíü ïèÿíà òà êîëëåãèàëüíîñòü ñîáñóæäåíèè , êîòîðàÿ îáû÷íî ñâîéñòâåííà ëþáèòåëÿì îáó÷àòü êîëëåã ìàñòåðñòâó äèàãíîñòèêè è ëå÷åíèÿ ( îñîáåíî ïñëå 5 ëåò ó÷àñòèÿ â êëèíè÷íåñêèõ èññëåäîîâàíèÿõ , íå èíà÷å , êàê Õåëüñèíñêîå ñîãëàøåíèå ó÷èò òàêèì ìàíåðàì )
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Ã.À. Ìåëüíè÷åíêî |
#15
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Íó òû è ïðèäóðîê, Ñëàâèê!
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