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BMJ Clinical Evidence Jul 2011Acute gastroenteritis results from infection of the gastrointestinal tract, most commonly with a virus. It is characterised by rapid onset of diarrhoea with or without... (Review)
Review
INTRODUCTION
Acute gastroenteritis results from infection of the gastrointestinal tract, most commonly with a virus. It is characterised by rapid onset of diarrhoea with or without vomiting, nausea, fever, and abdominal pain. Diarrhoea is defined as the frequent passage of unformed, liquid stools. Regardless of the cause, the mainstay of management of acute gastroenteritis is provision of adequate fluids to prevent and treat dehydration.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent acute gastroenteritis in children? What are the effects of treatments for acute gastroenteritis in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 42 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of: rotavirus vaccines for the prevention of gastroenteritis; enteral rehydration solutions (oral or gastric), lactose-free feeds, loperamide, probiotics, and zinc for the treatment of gastroenteritis; and ondansetron for the treatment of vomiting.
Topics: Acute Disease; Administration, Oral; Child; Dehydration; Gastroenteritis; Humans; Incidence; Infant; Loperamide; Nausea; Probiotics; Time Factors
PubMed: 21791124
DOI: No ID Found -
BMJ Clinical Evidence Jul 2007Seborrhoeic dermatitis affects at least 1-3% of the population. Malassezia (Pityrosporum) ovale is thought to be the causative organism, and causes inflammation... (Review)
Review
INTRODUCTION
Seborrhoeic dermatitis affects at least 1-3% of the population. Malassezia (Pityrosporum) ovale is thought to be the causative organism, and causes inflammation involving T cells and complement. Seborrhoeic dermatitis tends to relapse after treatment.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of topical treatments for seborrhoeic dermatitis of the scalp in adults? What are the effects of topical treatments for seborrhoeic dermatitis of the face and body in adults? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found nine systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: bifonazole, emollients, ketoconazole, lithium succinate, selenium sulphide, tar shampoo, terbinafine, and topical steroids (betamethasone valerate, clobetasol propionate, clobetasone butyrate, hydrocortisone, mometasone furate).
Topics: Administration, Oral; Administration, Topical; Dermatitis, Seborrheic; Face; Humans; Ketoconazole; Lithium; Malassezia; Remission Induction; Scalp Dermatoses
PubMed: 19454093
DOI: No ID Found -
International Journal of Cardiology May 2007A number of randomized controlled trials have compared self-management of oral anticoagulant therapy with conventional management. However, the results have not appeared... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A number of randomized controlled trials have compared self-management of oral anticoagulant therapy with conventional management. However, the results have not appeared consistent and a systematic review and meta-analysis are therefore needed in order to evaluate self-management of oral anticoagulant therapy. The aim of this study was to evaluate the efficacy and safety of self-management of oral anticoagulant therapy for patients on long-term oral anticoagulant therapy.
METHODS
A systematic review and meta-analysis including randomized controlled trials with highly selected patients comparing self-management of oral anticoagulant therapy with conventional treatment. Data were extracted in terms of study characteristics, quality of trials and outcome (death, minor and major complications (thromboembolic and bleeding events), and time within therapeutic INR target range).
RESULTS
Ten trials with a total of 2724 patients were included. Two of the trials could be classified as high quality trials. Considering all trials, self-management was associated with a reduced risk of death (relative risk (RR)=0.48, 95% confidence interval (CI) 0.29-0.79, p=0.004), major complications (RR=0.58, 95% CI 0.42-0.81, p=0.001) and with increasing time within therapeutic INR target range (weighted mean difference=6.53, 95% CI 2.24-10.82, p=0.003). No clear effect was found regarding minor complications (RR=0.98, 95% CI 0.49-1.99, p=0.96).
CONCLUSIONS
A majority of the existing trials have various methodological problems. However, self-management of oral anticoagulant therapy appeared at least as good and possible better than conventional management in highly selected patients.
Topics: Administration, Oral; Anticoagulants; Humans; International Normalized Ratio; Models, Statistical; Randomized Controlled Trials as Topic; Self Administration; Thromboembolism
PubMed: 16891008
DOI: 10.1016/j.ijcard.2006.06.018 -
BMJ Clinical Evidence Oct 2013Raynaud's phenomenon is an episodic, reversible vasospasm of the peripheral arteries (usually digital). It causes pallor, followed by cyanosis and/or redness, often with... (Review)
Review
INTRODUCTION
Raynaud's phenomenon is an episodic, reversible vasospasm of the peripheral arteries (usually digital). It causes pallor, followed by cyanosis and/or redness, often with pain and, at times, paraesthesia. On rare occasions, it can lead to ulceration of the fingers and toes (and, in some cases, of the ears or nose). This review focuses on primary (idiopathic) Raynaud's phenomenon, occurring in the absence of an underlying disease. The prevalence of primary Raynaud's phenomenon varies by sex, country, and exposure to workplace vibration.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of drug treatments for primary Raynaud's phenomenon? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 9 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: amlodipine, diltiazem, nicardipine, and nifedipine.
Topics: Administration, Oral; Humans; Nifedipine; Prevalence; Raynaud Disease; Ulcer; Vibration
PubMed: 24112969
DOI: No ID Found -
Journal of Cosmetic Dermatology Apr 2024Tranexamic acid (TA) is a new and promising drug for the treatment of melasma. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Tranexamic acid (TA) is a new and promising drug for the treatment of melasma.
OBJECTIVES
This network meta-analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma.
METHODS
We collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point.
RESULTS
At the Weeks 4, 8, and 12 and the last follow-up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8.
CONCLUSIONS
Among various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration.
Topics: Humans; Tranexamic Acid; Network Meta-Analysis; Melanosis; Administration, Oral; Time Factors; Treatment Outcome
PubMed: 38059683
DOI: 10.1111/jocd.16104 -
BMJ Clinical Evidence Jan 2011Up to 20% of adults aged over 55 years have detectable peripheral arterial disease of the legs, but this may cause symptoms of intermittent claudication in only a small... (Review)
Review
INTRODUCTION
Up to 20% of adults aged over 55 years have detectable peripheral arterial disease of the legs, but this may cause symptoms of intermittent claudication in only a small proportion of affected people. The main risk factors are smoking and diabetes mellitus, but other risk factors for cardiovascular disease are also associated with peripheral arterial disease.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for people with chronic peripheral arterial disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010. Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review. We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 70 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antiplatelet agents, bypass surgery, cilostazol, exercise, pentoxifylline, percutaneous transluminal angioplasty (PTA), prostaglandins, smoking cessation, and statins.
Topics: Administration, Oral; Angioplasty; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Intermittent Claudication; Peripheral Arterial Disease; Platelet Aggregation Inhibitors
PubMed: 21477401
DOI: No ID Found -
BMJ Clinical Evidence Nov 2007Crohn's disease is a long-term chronic condition of the gastrointestinal tract. It is characterised by transmural, granulomatous inflammation that occurs in a... (Review)
Review
INTRODUCTION
Crohn's disease is a long-term chronic condition of the gastrointestinal tract. It is characterised by transmural, granulomatous inflammation that occurs in a discontinuous pattern, with a tendency to form fistulae. The cause is unknown but may depend on interactions between genetic predisposition, environmental triggers, and mucosal immunity.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments in adults to induce remission in Crohn's disease? What are the effects of lifestyle interventions in adults with Crohn's disease to maintain remission? What are the effects of surgical interventions in adults with small-bowel Crohn's disease to induce remission? What are the effects of surgical interventions in adults with colonic Crohn's disease to induce remission? What are the effects of medical interventions to maintain remission in adults with Crohn's disease; and to maintain remission following surgery? We searched: Medline, Embase, The Cochrane Library and other important databases up to March 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 60 systematic reviews, RCTs, or observational studies that met our inclusion criteria.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: aminosalicylates, antibiotics, azathioprine/mercaptopurine, ciclosporin, corticosteroids (oral), enteral nutrition, fish oil, infliximab, methotrexate, probiotics, resection, segmental colectomy, smoking cessation, and strictureplasty.
Topics: Administration, Oral; Adrenal Cortex Hormones; Azathioprine; Colectomy; Crohn Disease; Enteral Nutrition; Humans; Life Style; Remission Induction
PubMed: 19450352
DOI: No ID Found -
Breast Cancer Research and Treatment Sep 2017In the past decade, there has been an increase in the development and use of oral anti-cancer medications (OAMs), especially for breast cancer-the most prevalent cancer... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
In the past decade, there has been an increase in the development and use of oral anti-cancer medications (OAMs), especially for breast cancer-the most prevalent cancer in women. However, adherence rates for OAMs are often suboptimal, leading to lower survival rate, increased risk of recurrence, and higher healthcare costs. Our goal was to identify potentially modifiable psychosocial facilitators and barriers that may be targeted to increase OAM adherence for breast cancer patients.
METHODS
We systematically searched PubMed for studies published in the U.S. by June 15, 2016 that addressed the following: (1) OAMs for breast cancer; (2) medication adherence; and (3) at least one psychosocial aspect of adherence.
RESULTS
Of the 1752 papers screened, 21 articles were included and analyzed. The most commonly reported motivators for adherence are patient-provider relationships (n = 11 studied, 82% reported significant association) and positive views and beliefs of medication (n = 9 studied, 89% reported significant association). We also identified consistent evidence of the impact of depression and emotions, perception of illness, concern of side effects, self-efficacy in medication management and decision making, knowledge of medication, and social support on OAM adherence.
CONCLUSIONS
Compared to traditional demographic, system, and clinical-related factors that have been well documented in the literature but are not easily changed, these cognitive, psychological, and interpersonal factors are more amendable via intervention and therefore could generate greater benefit in improving patient compliance and health outcomes. As OAMs shift treatment administration responsibility onto patients, continuous provider communication and education on illness and regimen are the keys to supporting patients' medication behavior.
Topics: Administration, Oral; Antineoplastic Agents; Breast Neoplasms; Female; Humans; Medication Adherence; Physician-Patient Relations; Quality of Life; Stress, Psychological
PubMed: 28573448
DOI: 10.1007/s10549-017-4317-2 -
BMJ Clinical Evidence Mar 2011Raynaud's phenomenon is an episodic vasospasm of the peripheral arteries, causing pallor, followed by cyanosis and redness with pain, and sometimes paraesthesia. On rare... (Review)
Review
INTRODUCTION
Raynaud's phenomenon is an episodic vasospasm of the peripheral arteries, causing pallor, followed by cyanosis and redness with pain, and sometimes paraesthesia. On rare occasions it can lead to ulceration of the fingers and toes (and in some cases of the ears or nose). This review focuses on primary (idiopathic) Raynaud's phenomenon, occurring in the absence of an underlying disease. The prevalence of primary Raynaud's phenomenon varies by sex, country, and exposure to workplace vibration.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for primary Raynaud's phenomenon? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 16 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: amlodipine, diltiazem, exercise, inositol nicotinate, keeping warm, moxisylyte (thymoxamine), naftidrofuryl oxalate, nicardipine, nifedipine, prazosin, and smoking cessation.
Topics: Administration, Oral; Humans; Nifedipine; Prevalence; Raynaud Disease; Ulcer; Vibration
PubMed: 21401971
DOI: No ID Found -
BMJ Clinical Evidence May 2007Premenstrual symptoms occur in 95% of women of reproductive age. Severe, debilitating symptoms (PMS) occur in about 5% of those women. There is no consensus on how... (Review)
Review
INTRODUCTION
Premenstrual symptoms occur in 95% of women of reproductive age. Severe, debilitating symptoms (PMS) occur in about 5% of those women. There is no consensus on how symptom severity should be assessed, which has led to a wide variety of symptoms scales, making it difficult to synthesise data on treatment efficacy. The cyclical nature of the condition also makes it difficult to conduct RCTs.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments; hormonal treatments; psychological interventions; physical therapies; dietary supplements; and surgical treatments in women with premenstrual syndrome? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 52 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, alprazolam, bright light therapy, buspirone, chiropractic manipulation, clomipramine, cognitive behavioural therapy, danazol, endometrial ablation, evening primrose oil, exercise, gonadorelin analogues, hysterectomy, laparoscopic bilateral oophorectomy, magnesium supplements, metolazone, non-steroidal anti-inflammatory drugs, oestrogens, oral contraceptives, progesterone, progestogens, pyridoxine, reflexology, relaxation, selective serotonin reuptake inhibitors, spironolactone, tibolone.
Topics: Administration, Oral; Contraceptives, Oral; Dietary Carbohydrates; Dietary Supplements; Evidence-Based Medicine; Female; Humans; Life Style; Magnesium; Phytotherapy; Premenstrual Syndrome; Pyridoxine
PubMed: 19454075
DOI: No ID Found