Evidence-based Healthcare最新文献_第8页

Magnesium sulphate given before birth does not significantly reduce death or cerebral palsy in premature babies, but may improve motor dysfunction 出生前给予硫酸镁并不能显著减少早产儿的死亡或脑瘫，但可能改善运动功能障碍

Evidence-based Healthcare Pub Date : 2004-06-01 Epub Date: 2004-04-21 DOI: 10.1016/j.ehbc.2004.03.003

Alistair Jan Gunn MBChB, FRACP, PhD, Laura Bennet PhD (Commentary Authors)

{"title":"Magnesium sulphate given before birth does not significantly reduce death or cerebral palsy in premature babies, but may improve motor dysfunction","authors":"Alistair Jan Gunn MBChB, FRACP, PhD, Laura Bennet PhD (Commentary Authors)","doi":"10.1016/j.ehbc.2004.03.003","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.003","url":null,"abstract":"<div><h3>Question</h3><p>Does giving magnesium sulphate to the mother during labour reduce the risk of cerebral palsy or death in premature babies?</p></div><div><h3>Study design</h3><p>Double blind randomised controlled trial.</p></div><div><h3>Main results</h3><p>Magnesium sulphate lowered, but did not significantly reduce, the risk of death or cerebral palsy compared with placebo (see Table 1). Magnesium sulphate significantly reduced the risk of substantial motor dysfunction compared with placebo. There were no major adverse effects in the mother, although minor adverse events were more frequent with magnesium sulphate compared with placebo (RR 2.74, 95% CI 1.81 to 4.15).<span><div><div><table><tbody><tr><td><strong>Table 1</strong>. Death, cerebral palsy and motor dysfunction of infants at 2 years of age.</td></tr><tr><td></td><td>Magnesium sulphate (n=629)</td><td>Placebo N=626</td><td>RR magnesium sulphate vs placebo (95% CI)</td></tr><tr><td>Total deaths, <em>n</em> (%)</td><td>87 (14)</td><td>107 (17)</td><td>0.83 (0.64 to 1.09)</td></tr><tr><td>Cerebral palsy, <em>n</em> (%)</td><td>36 (7)</td><td>42 (8)</td><td>0.83 (0.54 to 1.27)</td></tr><tr><td>Substantial gross motor dysfunction, <em>n</em> (%)</td><td>18 (3)</td><td>34 (7)</td><td>0.51 (0.29 to 0.91)</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ conclusions</h3><p>Magnesium sulphate provides some protection against nerve damage in premature babies and should be investigated in future trials.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 162-164"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cannabinoids do not reduce objective measurements in muscle spasticity, but people with multiple sclerosis perceive some benefit 大麻素不会减少肌肉痉挛的客观测量，但多发性硬化症患者会感受到一些好处

Evidence-based Healthcare Pub Date : 2004-06-01 Epub Date: 2004-04-21 DOI: 10.1016/j.ehbc.2004.03.014

Franjo Grotenhermen MD (Commentary Author)

{"title":"Cannabinoids do not reduce objective measurements in muscle spasticity, but people with multiple sclerosis perceive some benefit","authors":"Franjo Grotenhermen MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.014","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.014","url":null,"abstract":"<div><h3>Question</h3><p>Do cannabinoids have a beneficial effect on muscle spasticity and other symptoms associated with multiple sclerosis?</p></div><div><h3>Study Design</h3><p>Double-blind randomised placebo controlled trial.</p></div><div><h3>Main Results</h3><p>At 15 weeks, neither cannabis extract nor Δ<sup>9</sup>-tetrahydrocannabinol (THC) reduced muscle spasticity, compared with placebo (mean difference in Ashworth score: cannabis extract vs. placebo 0.32, 95% CI −1.04 to 1.67; THC vs. placebo 0.94, 95% CI −0.44 to 2.31). Participants taking cannabinoids reported improvements in mobility, pain, sleep quality, spasms and spasticity, but not irritability, depression, tiredness, tremor or energy (see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Results of primary and secondary outcomes.</td></tr><tr><td></td><td>Cannabis extract</td><td>THC</td><td>Placebo</td><td>P value (baseline to follow-up)</td></tr><tr><td><em>Primary and objective outcomes</em></td></tr><tr><td>Mean change from baseline in Ashworth scores</td><td>1.24</td><td>1.86</td><td>0.92</td><td>0.4</td></tr><tr><td>Reduction in median time taken to walk 10m (95% CI)</td><td>4% (0 to 10)</td><td>12% (6 to 21)</td><td>4% (−2 to 7)</td><td>0.015</td></tr><tr><td><em>Secondary, subjective outcomes: percentage of participants whose symptoms improved relative to baseline</em></td></tr><tr><td>Pain</td><td>46%</td><td>50%</td><td>30%</td><td>0.002</td></tr><tr><td>Spasticity</td><td>52%</td><td>51%</td><td>37%</td><td>0.010</td></tr><tr><td>Spasms</td><td>53%</td><td>49%</td><td>39%</td><td>0.038</td></tr><tr><td>Sleep</td><td>50%</td><td>47%</td><td>36%</td><td>0.025</td></tr><tr><td>Tiredness</td><td>28%</td><td>22%</td><td>22%</td><td>0.068</td></tr><tr><td>Shake/tremor</td><td>38%</td><td>41%</td><td>33%</td><td>0.398</td></tr><tr><td>Energy</td><td>33%</td><td>35%</td><td>24%</td><td>0.140</td></tr><tr><td>Irritability</td><td>39%</td><td>33%</td><td>26%</td><td>0.619</td></tr><tr><td>Depression</td><td>36%</td><td>29%</td><td>28%</td><td>0.298</td></tr></tbody></table></div></div></span></p></div><div><h3>Authors’ Conclusions</h3><p>Although cannabinoids are not beneficial for treating spasticity measured by the Ashworth score, they are useful for treating other symptoms of multiple sclerosis.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 159-161"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Ultraviolet germicidal irradiation of office ventilation systems reduces work-related mucosal and respiratory symptoms 办公室通风系统的紫外线杀菌照射可减少与工作有关的粘膜和呼吸道症状

Evidence-based Healthcare Pub Date : 2004-06-01 DOI: 10.1016/J.EHBC.2004.03.022

K. Kühn, I. Chaberny

引用次数: 1

Breast-feeding has little effect on blood pressure in later life☆ 母乳喂养对以后的血压几乎没有影响

Evidence-based Healthcare Pub Date : 2004-06-01 DOI: 10.1016/J.EHBC.2004.03.011

U. Das

引用次数: 3

Risk of venous thromboembolism greatest within two weeks of long-haul flight☆ 长途飞行两周内静脉血栓栓塞的风险最大

Evidence-based Healthcare Pub Date : 2004-06-01 DOI: 10.1016/J.EHBC.2004.03.017

F. Paganin

引用次数: 1

A community-based disease management program for postmyocardial infarction reduces hospital readmissions compared with usual care 与常规护理相比，以社区为基础的心肌梗死后疾病管理方案减少了再入院率

Evidence-based Healthcare Pub Date : 2004-06-01 DOI: 10.1016/J.EHBC.2004.03.013

J. Ghali

引用次数: 4

Do For-profit health plans restrict access to high-cost procedures? 营利性医疗计划是否会限制高成本的医疗程序?

Evidence-based Healthcare Pub Date : 2004-06-01 Epub Date: 2004-05-10 DOI: 10.1016/j.ehbc.2004.03.021

Antonio J Trujillo PhD (Commentary Author)

{"title":"Do For-profit health plans restrict access to high-cost procedures?","authors":"Antonio J Trujillo PhD (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.021","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.021","url":null,"abstract":"<div><h3>Question</h3><p>Do for-profit health plans restrict access to high-cost procedures compared with not-for-profit health plans?</p></div><div><h3>Study design</h3><p>Cohort study.</p></div><div><h3>Main results</h3><p>In unadjusted analyses, for-profit health plan beneficiaries had higher rates of all high-cost procedures than not-for-profit health plan beneficiaries; the difference was significant for 4 out of 12 procedures (see Table 1). Rates of usage remained higher in for-profit plans after adjustment for participants’ sociodemographic factors, county of residence, and health plan characteristics (see Table 1).<span><div><div><table><tbody><tr><td><strong>Table 1</strong> Difference in rates of high-cost procedures between for-profit plans and not-for-profit plans.</td></tr><tr><td>Procedure</td><td>Difference per 10,000 beneficiaries (95% CI)</td></tr><tr><td></td><td>Unadjusted</td><td>Adjusted for sociodemographic factors<sup>∗</sup></td><td>Adjusted for health plan characteristics<sup>†</sup>, sociodemographic</td><td>Adjusted for county of residence<sup>‡</sup>, sociodemographic factors, health plan characteristics</td></tr><tr><td>Hysterectomy</td><td>2.6 (−0.3 to 5.5)</td><td>2.7 (−0.2 to 5.6)</td><td>2.2 (−1.0 to 5.4)</td><td>2.5 (0.6 to 4.3)<sup>§</sup></td></tr><tr><td>Prostatectomy</td><td>4.3 (−1.4 to 10.1)</td><td>3.8 (−1.9 to 9.6)</td><td>3.3 (−3.1 to 9.8)</td><td>6.3 (0.2 to 12.3)<sup>§</sup></td></tr><tr><td>Closed cholecystectomy</td><td>5.8 (−0.2 to 11.9)</td><td>6.1 (0.1 to 12.1)<sup>§</sup></td><td>7.0 (0.4 to 13.6)<sup>§</sup></td><td>7.7 (3.4 to 11.9)<sup>§</sup></td></tr><tr><td>Open cholecystectomy</td><td>0.8 (−1.6 to 3.1)</td><td>0.8 (−1.5 to 3.2)</td><td>0.6 (−2.1 to 3.3)</td><td>1.9 (−0.1 to 3.8)</td></tr><tr><td>Partial colectomy</td><td>4.0 (−1.0 to 9.0)</td><td>4.4 (−0.6 to 9.4)</td><td>6.0 (0.3 to 11.6)<sup>§</sup></td><td>8.4 (4.8 to 12.0)<sup>§</sup></td></tr><tr><td>Reduction of femur fracture</td><td>2.6 (−2.9 to 8.2)</td><td>6.0 (0.5 to 11.4)<sup>§</sup></td><td>5.3 (−0.9 to 11.4)</td><td>6.4 (1.1 to 11.6)<sup>§</sup></td></tr><tr><td>Total knee replacement</td><td>5.1 (−1.0 to 11.2)</td><td>5.1 (−0.9 to 11.2)</td><td>5.7 (−0.9 to 12.4)</td><td>8.3 (3.1 to 13.6)<sup>§</sup></td></tr><tr><td>Total hip replacement</td><td>2.4 (−5.1 to 10.0)</td><td>3.0 (−4.5 to 10.5)</td><td>2.3 (−6.2 to 10.9)</td><td>5.4 (0.8 to 9.9)<sup>§</sup></td></tr><tr><td>Cardiac catheterisation</td><td>31.6 (9.0 to 54.2)<sup>§</sup></td><td>31.0 (8.7 to 53.3)<sup>§</sup></td><td>15.2 (−9.2 to 39.5)</td><td>26.5 (14.1 to 38.9)<sup>§</sup></td></tr><tr><td>Coronary artery bypass grafting</td><td>10.3 (2.5 to 15.1)<sup>§</sup></td><td>10.7 (3.1 to 18.3)<sup>§</sup></td><td>7.6 (−1.0 to 16.2)</td><td>6.3 (0 to 12.7)<sup>§</sup></td></tr><tr><td>Percutaneous transluminal coronary angioplasty</td><td>8.5 (1.0 to 16.1)<sup>§</sup></td><td>9.0 (1.6 to 16.4)<sup>§</sup></td><td>6.0 (−2.3 to 14.3)</td><td>2.6 (−2.8 to 8.0)</td></tr><t","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 116-118"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Risk of AIDS increases in children aged 2 years and older with CD4 T cell percentage less than 15% CD4 T细胞百分比低于15%的2岁及以上儿童患艾滋病的风险增加

Evidence-based Healthcare Pub Date : 2004-06-01 Epub Date: 2004-05-06 DOI: 10.1016/j.ehbc.2004.03.019

William J Moss MD,MPH (Commentary Author) , Deborah Persaud MD (Commentary Author)

{"title":"Risk of AIDS increases in children aged 2 years and older with CD4 T cell percentage less than 15%","authors":"William J Moss MD,MPH (Commentary Author) , Deborah Persaud MD (Commentary Author)","doi":"10.1016/j.ehbc.2004.03.019","DOIUrl":"https://doi.org/10.1016/j.ehbc.2004.03.019","url":null,"abstract":"<div><h3>Question</h3><p>What is the short-term risk of disease progression in children infected perinatally with HIV-1?</p></div><div><h3>Study design</h3><p>Meta-analysis.</p></div><div><h3>Main results</h3><p>Eight cohort studies and nine randomized controlled trials in 3941 children infected perinatally with HIV-1 were identified. The risk of AIDS or death increased across all age groups with decreasing CD4 T cell percentage (CD4%). Children aged ≤2 years had the most pronounced increase in risk within 12 months with decreasing CD4% compared with children aged 5 to 10 years (CD4%<span><sup>1</sup></span> at which probability of death increases: 20% to 25% for children aged 6 months to 2 years vs. 10% to 15% for children aged 5 to 10 years; CD4% at which probability of AIDS increases: 25% to 30% for children aged 6 months to 2 years vs. 12% to 20% for children aged 5 to 10 years). Risk of disease progression increased with increasing viral load although the correlation was more gradual compared with CD4%.</p></div><div><h3>Authors’ conclusions</h3><p>Risk of disease progression in children infected with HIV-1 is strongly associated with low CD4%, particularly in children aged ≤2 years.</p></div>","PeriodicalId":100512,"journal":{"name":"Evidence-based Healthcare","volume":"8 3","pages":"Pages 168-170"},"PeriodicalIF":0.0,"publicationDate":"2004-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehbc.2004.03.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71829103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Echinacea purpurea is ineffective for upper respiratory tract infections in children 紫锥菊对小儿上呼吸道感染无效

Evidence-based Healthcare Pub Date : 2004-06-01 DOI: 10.1016/J.EHBC.2004.03.010

A. Mainous

引用次数: 4

Biennial screening mammography is cost effective in healthy women aged over 65 years 在65岁以上的健康妇女中，两年一次的乳房x光检查具有成本效益

Evidence-based Healthcare Pub Date : 2004-06-01 DOI: 10.1016/J.EHBC.2004.03.015

P. Carney

引用次数: 1