Evidence-based child health : a Cochrane review journal最新文献

{"title":"Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (Review)","authors":"Luz Maria De-Regil,&nbsp;Parminder S Suchdev,&nbsp;Gunn E Vist,&nbsp;Silke Walleser,&nbsp;Juan Pablo Peña-Rosas","doi":"10.1002/ebch.1895","DOIUrl":"10.1002/ebch.1895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vitamin and mineral deficiencies, particularly those of iron, vitamin A and zinc, affect more than two billion people worldwide. Young children are highly vulnerable because of rapid growth and inadequate dietary practices. Micronutrient powders (MNP) are single-dose packets containing multiple vitamins and minerals in powder form that can be sprinkled onto any semi-solid food.The use of MNP for home or point-of-use fortification of complementary foods has been proposed as an intervention for improving micronutrient intake in children under two years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the effects and safety of home (point-of-use) fortification of foods with multiple micronutrient powders on nutritional, health and developmental outcomes in children under two years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search methods</h3>\u0000 \u0000 <p>We searched the following databases in February 2011: Cochrane Central Register of Controlled Trials (CENTRAL) (<i>The Cochrane Library</i>), MEDLINE (1948 to week 2 February 2011), EMBASE (1980 to Week 6 2011), CINAHL (1937 to current), CPCI-S (1990 to 19 February 2011), Science Citation Index (1970 to 19 February 2011), African Index Medicus (searched 23 February 2011), POPLINE (searched 21 February 2011), ClinicalTrials.gov (searched 23 February 2011), mRCT (searched 23 February 2011), and World Health Organization International Clinical Trials Registry Platform (ICTRP) (searched 23 February 2011). We also contacted relevant organisations (25 January 2011) for the identification of ongoing and unpublished studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>We included randomised and quasi-randomised trials with either individual or cluster randomisation. Participants were children under the age of two years at the time of intervention, with no specific health problems. The intervention was consumption of food fortified at the point of use with multiple micronutrient powders formulated with at least iron, zinc and vitamin A compared with placebo, no intervention or the use of iron containing supplements, which is the standard practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Two review authors independently assessed the eligibility of studies against the inclusion criteria, extracted data from included studies and assessed the risk of bias of the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>We included eight trials ","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600933","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}

{"title":"Cochrane Review: Screening programmes for developmental dysplasia of the hip in newborn infants","authors":"Damon Shorter,&nbsp;Timothy Hong,&nbsp;David A Osborn","doi":"10.1002/ebch.1891","DOIUrl":"10.1002/ebch.1891","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Uncorrected developmental dysplasia of the hip (DDH) is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the effect of different screening programmes for DDH on the incidence of late presentation of congenital hip dislocation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search methods</h3>\u0000 \u0000 <p>Searches were performed in CENTRAL (<i>The Cochrane Library</i>), MEDLINE and EMBASE (January 2011) supplemented by searches of clinical trial registries, conference proceedings, cross references and contacting expert informants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>Randomised, quasi-randomised or cluster trials comparing the effectiveness of screening programmes for DDH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Three independent review authors assessed study eligibility and quality, and extracted data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>No study examined the effect of screening (clinical and/or ultrasound) and early treatment versus not screening and later treatment.</p>\u0000 \u0000 <p>One study reported universal ultrasound compared to clinical examination alone did not result in a significant reduction in late diagnosed DDH or surgery but was associated with a significant increase in treatment.</p>\u0000 \u0000 <p>One study reported targeted ultrasound compared to clinical examination alone did not result in a significant reduction in late diagnosed DDH or surgery, with no significant difference in rate of treatment.</p>\u0000 \u0000 <p>Meta-analysis of two studies found universal ultrasound compared to targeted ultrasound did not result in a significant reduction in late diagnosed DDH or surgery. There was heterogeneity between studies reporting the effect on treatment rate.</p>\u0000 \u0000 <p>Meta-analysis of two studies found delayed ultrasound and targeted splinting compared to immediate splinting of infants with unstable (but not dislocated) hips resulted in no significant difference in the rate of late diagnosed DDH. Both studies reported a significant reduction in treatment with use of delayed ultrasound and targeted splinting.</p>\u0000 \u0000 <p>One study reported delayed ultrasound and targeted splinting compared to immediate splinting of infants with mild hip dysplasia on ultrasound resulted in no significa","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600929","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}

{"title":"Commentary on ‘Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age’","authors":"Marzia Lazzerini","doi":"10.1002/ebch.1896","DOIUrl":"10.1002/ebch.1896","url":null,"abstract":"<p>This is a commentary on a Cochrane review, published in this issue of EBCH, first published as: De-Regil L, Suchdev PS, Vist GE, Walleser S, Pena-Rosas JP. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age. <i>Cochrane Database of Systematic Reviews</i> 2011, Issue 9. Art. N.: CD008959. DOI: 10.1002/14651858.CD008959.pub2. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley &amp; Sons, Ltd. The Cochrane Collaboration</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600934","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}

{"title":"Cochrane Review: Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants","authors":"Charles I Okwundu,&nbsp;Christy AN Okoromah,&nbsp;Prakeshkumar S Shah","doi":"10.1002/ebch.1898","DOIUrl":"10.1002/ebch.1898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Low birth weight and premature infants are at major risk for exaggerated hyperbilirubinaemia and jaundice that can lead to bilirubin encephalopathy. Phototherapy is the most common treatment for neonatal hyperbilirubinaemia and could be most effective in preventing the sequelae of hyperbilirubinaemia if initiated prophylactically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of prophylactic phototherapy for preterm (&lt; 37 weeks gestational age) or low birth weight infants (birth weight &lt; 2500 g).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search methods</h3>\u0000 \u0000 <p>We searched the Cochrane Central Register of Controlled Trials (CENTRAL, T<i>he Cochrane Library</i>, Issue 3) on 31 March 2011, MEDLINE (1950 to 31 March 2011), EMBASE (1980 to 31 March 2011) and CINAHL (1982 to 31 March 2011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>Randomised controlled trials or quasi-randomised controlled studies evaluating the effects of prophylactic phototherapy for preterm or low birth weight infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Two authors independently obtained data from published articles. We performed fixed-effect meta-analysis for the outcomes: rate of exchange transfusion, cerebral palsy or other neurodevelopmental impairment, peak serum bilirubin level and all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>Nine studies of 3449 participants were included. The rate of exchange transfusion was reduced in one study with liberal transfusion criteria (risk ratio (RR) 0.20; 95% confidence interval (CI) 0.13 to 0.31) but not in the other two more recent studies with stringent criteria (typical RR 0.66; 95% CI 0.19 to 2.28). There was no statistically significant difference in the rate of cerebral palsy (typical RR 0.96; 95% CI 0.50 to 1.85; two studies, 756 participants). However, one large study that reported on neurodevelopmental impairment (a composite outcome including cerebral palsy) found a slightly lower rate of neurodevelopmental impairment with prophylactic phototherapy (RR 0.85; 95% CI 0.74 to 0.99; 1804 participants). The prophylactic phototherapy group had lower peak bilirubin levels (mean difference (MD) -2.73; 95% CI -2.89 to -2.57; six studies, 2319 participants) and had fewer neonates with peak unconjugated serum bilirubin levels &gt; 10 mg/dl (typical RR 0.27; 95% CI 0.22 to 0.33; three studies, 1090 participants) or peak unconj","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1898","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600935","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}

{"title":"Erratum: The Cochrane Library and treatment of patent ductus arteriosus: an overview of reviews","authors":"J. Harrold,&nbsp;T. Lacaze-Masmonteil,&nbsp;L. Hartling,&nbsp;M. Oleszczuk","doi":"10.1002/ebch.1900","DOIUrl":"https://doi.org/10.1002/ebch.1900","url":null,"abstract":"<p>The above article was published in EBCH <b>7</b>:1185–1195 (2012). DOI:10.1002/ebch.1855 Copyright © 2013 The Cochrane Collaboration. Published by John Wiley &amp; Sons, Ltd. The Cochrane Collaboration</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137805603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on ‘Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants’","authors":"Mark W. Davies","doi":"10.1002/ebch.1899","DOIUrl":"10.1002/ebch.1899","url":null,"abstract":"This is a commentary on a Cochrane review, published in this issue of EBCH, first published as:Okwundu CI, Okoromah CAN, Shah PS. Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants. Cochrane Database of Systematic Reviews 2012, Issue 1. Art. No.: CD007966. DOI: 10.1002/14651858.CD007966.pub2. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600936","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}

{"title":"Cochrane Review: Osmotic and stimulant laxatives for the management of childhood constipation (Review)","authors":"Morris Gordon,&nbsp;Khimara Naidoo,&nbsp;Anthony K Akobeng,&nbsp;Adrian G Thomas","doi":"10.1002/ebch.1893","DOIUrl":"10.1002/ebch.1893","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Constipation within childhood is an extremely common problem. Despite the widespread use of osmotic and stimulant laxatives by health professionals to manage constipation in children, there has been a long standing paucity of high quality evidence to support this practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We set out to evaluate the efficacy and safety of osmotic and stimulant laxatives used to treat functional childhood constipation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search methods</h3>\u0000 \u0000 <p>The search (inception to May 7, 2012) was standardised and not limited by language and included electronic searching (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register), reference searching of all included studies, personal contacts and drug companies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>Randomised controlled trials (RCTs) which compared osmotic or stimulant laxatives with either placebo or another intervention, with patients aged 0 to 18 years old were considered for inclusion. The primary outcome was frequency of defecation. Secondary endpoints included faecal incontinence, disimpaction, need for additional therapies and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Relevant papers were identified and the authors independently assessed the eligibility of trials. Methodological quality was assessed using the Cochrane risk of bias tool.The Cochrane RevMan software was used for analyses. Patients with final missing outcomes were assumed to have relapsed. For continuous outcomes we calculated a mean difference (MD) and 95% confidence interval (CI) using a fixed-effect model. For dichotomous outcomes we calculated an odds ratio (OR) and 95% confidence intervals (95% CI) using a fixed-effect model. The chi square and I² statistics were used to assess statistical heterogeneity. A random-effects model was used in situations of unexplained heterogeneity</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>Eighteen RCTs (1643 patients) were included in the review. Nine studies were judged to be at high risk of bias due to lack of blinding, incomplete outcome data and selective reporting. Meta-analysis of two studies (101 patients) comparing polyethylene glycol (PEG) with placebo showed a significantly increased number of stools per week with PEG (MD 2.61 stools pe","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600931","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}

{"title":"Commentary on ‘Non-pharmacological management of infant and young child procedural pain’ with a response from the review authors","authors":"Patrick J. McGrath,&nbsp;Jill Chorney,&nbsp;Rebecca Pillai Riddell,&nbsp;Nicole Racine,&nbsp;Kara Turcotte,&nbsp;Lindsay Uman,&nbsp;Diana Lisi","doi":"10.1002/ebch.1884","DOIUrl":"10.1002/ebch.1884","url":null,"abstract":"<p>These are commentaries on a Cochrane review, published in this issue of EBCH, first published as: Pillai Riddell RR, Racine NM, Turcotte K, Uman LS, Horton RE, Din Osmun L, Ahola Kohut S, Hillgrove Stuart J, Stevens B, Gerwitz-Stern A. Non-pharmacological management of infant and young child procedural pain. <i>Cochrane Database of Systematic Reviews</i> 2011, Issue 10. Art. No.: CD006275. DOI: 10.1002/14651858. CD006275.pub2.</p><p>Further information for this Cochrane review is available in this issue of EBCH in the accompanying Summary article. Copyright © 2012 The Cochrane Collaboration. Published by John Wiley &amp; Sons, Ltd. The Cochrane Collaboration</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83109298","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}

{"title":"Cochrane Review: Probiotics for prevention of necrotizing enterocolitis in preterm infants","authors":"Khalid AlFaleh,&nbsp;Jasim Anabrees,&nbsp;Dirk Bassler,&nbsp;Turki Al-Kharfi","doi":"10.1002/ebch.1881","DOIUrl":"https://doi.org/10.1002/ebch.1881","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Necrotizing enterocolitis (NEC) and nosocomial sepsis are associated with increased morbidity and mortality in preterm infants. Through prevention of bacterial migration across the mucosa, competitive exclusion of pathogenic bacteria, and enhancing the immune responses of the host, prophylactic enteral probiotics (live microbial supplements) may play a role in reducing NEC and associated morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the efficacy and safety of prophylactic enteral probiotics administration versus placebo or no treatment in the prevention of severe NEC and/or sepsis in preterm infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search methods</h3>\u0000 \u0000 <p>For this update, searches were made of MEDLINE (1966 to October 2010), EMBASE (1980 to October 2010), the Cochrane Central Register of Controlled Trials <i>(</i>CENTRAL, <i>The Cochrane Library,</i> Issue 2, 2010), and abstracts of annual meetings of the Society for Pediatric Research (1995 to 2010).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>Only randomized or quasi-randomized controlled trials that enrolled preterm infants &lt; 37 weeks gestational age and/or &lt; 2500 g birth weight were considered. Trials were included if they involved enteral administration of any live microbial supplement (probiotics) and measured at least one prespecified clinical outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Standard methods of the Cochrane Collaboration and its Neonatal Group were used to assess the methodologic quality of the trials, data collection and analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>Sixteen eligible trials randomizing 2842 infants were included. Included trials were highly variable with regard to enrollment criteria (i.e. birth weight and gestational age), baseline risk of NEC in the control groups, timing, dose, formulation of the probiotics, and feeding regimens. Data regarding extremely low birth weight infants (ELBW) could not be extrapolated. In a meta-analysis of trial data, enteral probiotics supplementation significantly reduced the incidence of severe NEC (stage II or more) (typical RR 0.35, 95% CI 0.24 to 0.52) and mortality (typical RR 0.40, 95% CI 0.27 to 0.60). There was no evidence of significant reduction of nosocomial sepsis (typical RR 0.90, 95% CI 0.76 to 1.07). The included trials reported no systemic infection with the probiotics supplemental organism. The statistical test ","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137646442","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}

{"title":"The Cochrane Library and safety of regular long-acting beta2- agonists in children with asthma: an overview of reviews","authors":"Christopher J. Cates,&nbsp;Elizabeth Stovold,&nbsp;Susan Wieland,&nbsp;Marta Oleszczuk,&nbsp;Denise Thomson,&nbsp;Lorne Becker","doi":"10.1002/ebch.1889","DOIUrl":"10.1002/ebch.1889","url":null,"abstract":"<p><b>Background:</b> Two large randomized trials of regular salmeterol monotherapy in adults with asthma found an increased risk of asthma-related mortality for salmeterol versus placebo or regular salbutamol. There are no similar large trials in children, and the safety of monotherapy with salmeterol or other long-acting beta₂-agonists in children with asthma is unclear. Current guidelines recommend that regular long-acting beta₂-agonist therapy should be given only in combination with regular inhaled corticosteroids. However, the safety of combination therapy in children with asthma is also unclear.</p><p><b>Objectives:</b> We used the paediatric trial results from Cochrane systematic reviews to assess the safety of regular long-acting beta₂-agonist therapy, either as monotherapy or as combination therapy with inhaled corticosteroids, in children with asthma.</p><p><b>Methods:</b> We searched the Cochrane Database of Systematic Reviews in May 2012 for Cochrane reviews relating to the safety of regular formoterol and salmeterol, and ran updated searches for trials for each of the Cochrane reviews. We used odds ratios (ORs) to summarize the direct randomized evidence on safety from trials comparing regular formoterol or regular salmeterol as monotherapy versus placebo and then as combination therapy with inhaled corticosteroids versus the same dose of inhaled corticosteroids. We indirectly compared the safety of monotherapy and combination therapy by testing for differences between the pooled ORs for monotherapy and for combination therapy. We used ORs to summarize the direct randomized evidence on safety from trials comparing regular formoterol with regular salmeterol. We also compared the safety of regular formoterol and regular salmeterol indirectly by calculating an OR for the pooled results of trials assessing formoterol and the pooled results of trials assessing salmeterol, and then combined the direct and indirect evidence by calculating an overall OR for this comparison.</p><p><b>Results:</b> We identified four Cochrane reviews examining the safety of regular formoterol or salmeterol as either monotherapy or combination therapy. The reviews included 19 trials in children and we found two additional studies on salmeterol combination therapy, for a total of 21 trials in 7318 children. We identified two Cochrane reviews comparing the safety of formoterol with salmeterol, which included a single trial in 156 children. We found a statistically significant increase in the odds of suffering a nonfatal serious adverse event in children on formoterol monotherapy [OR = 2.48; 95% confidence interval (CI) = 1.27–4.83, <i>I</i>² = 0%, five trials, <i>N</i> = 1335] and smaller nonsignificant increases in odds for salmeterol monotherapy (OR = 1.30; 95% CI = 0.82–2.05, <i>I</i>² = 17%, five trials, <i>N</i> = 1333), formoterol combination therapy (OR = 1.60; 95% CI = 0.80–3.28, <i>I</i>² ","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77807678","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}