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

{"title":"Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections","authors":"Philipp Schuetz,&nbsp;Beat Muller,&nbsp;Mirjam Christ-Crain,&nbsp;Daiana Stolz,&nbsp;Michael Tamm,&nbsp;Lila Bouadma,&nbsp;Charles E Luyt,&nbsp;Michel Wolff,&nbsp;Jean Chastre,&nbsp;Florence Tubach,&nbsp;Kristina B Kristoffersen,&nbsp;Olaf Burkhardt,&nbsp;Tobias Welte,&nbsp;Stefan Schroeder,&nbsp;Vandack Nobre,&nbsp;Long Wei,&nbsp;Neera Bhatnagar,&nbsp;Heiner C Bucher,&nbsp;Matthias Briel","doi":"10.1002/ebch.1927","DOIUrl":"10.1002/ebch.1927","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute respiratory infections (ARIs) comprise a large and heterogeneous group of infections including bacterial, viral and other aetiologies. In recent years, procalcitonin - the prohormone of calcitonin - has emerged as a promising marker for the diagnosis of bacterial infections and for improving decisions about antibiotic therapy. Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with acute respiratory infections and different settings ranging from primary care to emergency departments (EDs), hospital wards and intensive care units (ICUs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this systematic review based on individual patient data was to assess the safety and efficacy of using procalcitonin for starting or stopping antibiotics over a large range of patients with varying severity of ARIs and from different clinical settings.</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 2011, Issue 2) which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to May 2011) and EMBASE (1974 to May 2011) to identify suitable trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>We included RCTs of adult participants with ARIs who received an antibiotic treatment either based on a procalcitonin algorithm or usual care/guidelines. Trials were excluded if they exclusively focused on paediatric patients or if they used procalcitonin for another purpose than to guide initiation and duration of antibiotic treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Two teams of review authors independently evaluated the methodology and extracted data from primary studies. The primary endpoints were all-cause mortality and treatment failure at 30 days. For the primary care setting, treatment failure was defined as death, hospitalisation, ARI-specific complications, recurrent or worsening infection, and patients reporting any symptoms of an ongoing respiratory infection at follow-up. For the ED setting, treatment failure was defined as death, ICU admission, re-hospitalisation after index hospital discharge, ARI-associated complications, and recurrent or worsening infection within 30 days of follow-up. For the ICU setting, treatment failure was defined as death within 30 days of follow-up. Secondary endpoints were antibiotic use (initiation of antibiotics, dur","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1927","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600572","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":"Prophylactic drug management for febrile seizures in children (Review)","authors":"Martin Offringa,&nbsp;Richard Newton","doi":"10.1002/ebch.1921","DOIUrl":"10.1002/ebch.1921","url":null,"abstract":"BACKGROUND\u0000Febrile seizures occurring in a child older than one month during an episode of fever affect 2% to 4% of children in Great Britain and the United States and recur in 30%. Rapid-acting antiepileptics and antipyretics given during subsequent fever episodes have been used to avoid the adverse effects of continuous antiepileptic drugs.\u0000\u0000\u0000OBJECTIVES\u0000To evaluate the effectiveness and safety of antiepileptic and antipyretic drugs used prophylactically to treat children with febrile seizures.\u0000\u0000\u0000SEARCH METHODS\u0000We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011. Issue 3); MEDLINE (1966 to May 2011); EMBASE (1966 to May 2011); Database of Abstracts of Reviews of Effectiveness (DARE) (May 2011). No language restrictions were imposed. We also contacted researchers in the field to identify continuing or unpublished studies.\u0000\u0000\u0000SELECTION CRITERIA\u0000Trials using randomised or quasi-randomised patient allocation that compared the use of antiepileptic or antipyretic agents with each other, placebo or no treatment.\u0000\u0000\u0000DATA COLLECTION AND ANALYSIS\u0000Two review authors (RN and MO) independently applied pre-defined criteria to select trials for inclusion and extracted the pre-defined relevant data, recording methods for randomisation, blinding and exclusions. Outcomes assessed were seizure recurrence at 6, 12, 18, 24, 36 months and at age 5 to 6 years in the intervention and non-intervention groups, and adverse medication effects. The presence of publication bias was assessed using funnel plots.\u0000\u0000\u0000MAIN RESULTS\u0000Thirty-six articles describing 26 randomised trials with 2740 randomised participants were included. Thirteen interventions of continuous or intermittent prophylaxis and their control treatments were analysed. Methodological quality was moderate to poor in most studies. We could not do a meta-analysis for eight of the 13 comparisons due to insufficient numbers of trials. No significant benefit for valproate, pyridoxine, intermittent phenobarbitone or ibuprofen versus placebo or no treatment was found; nor for diclofenac versus placebo followed by ibuprofen, acetominophen or placebo; nor for intermittent rectal diazepam versus intermittent valproate, nor phenobarbitone versus intermittent rectal diazepam. There was a significant reduction of recurrent febrile seizures with intermittent oral diazepam versus placebo with a relative risk (RR) of 0.67 (95% confidence interval (CI) 0.48 to 0.94) at 24 months), RR of 0.61 (95% CI 0.15 to 0.89) at 48 months, with no benefit at 6, 12 or 72 months. Phenobarbitone versus placebo or no treatment reduced seizures at 6, 12 and 24 months but not at 18 or 72 month follow up (RR 0.60, 95% CI 0.42 to 0.84 at 6 months; RR 0.59, 95% CI 0.46 to 0.75 at 12 months; and RR 0.65, 95% CI 0.49 to 0.88 at 24 months). Intermittent rectal diazepam versus no treatment or placebo also reduced seizures (RR 0.60, 95% CI 0.41 to 0.86 at 6 months; RR 0.65, 95% CI 0.49 to 0.87 at 12 months; RR 0","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600513","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":"More research is needed","authors":"Joan L. Robinson","doi":"10.1002/ebch.1931","DOIUrl":"10.1002/ebch.1931","url":null,"abstract":"I typically start my editorials by commenting on the Canadian weather as people here spend more time talking about the weather than they do about what is really happening in the world. It is now mid-May, which means that I can cycle to work today, yet I am headed to the mountains this weekend for one last downhill ski. I am not aware of any evidence on the long-term outcomes of living with erratic weather versus the ‘boring’ weather that those in more southern climates have to cope with. Many decisions made each day in pediatric offices and emergency departments would be simpler if there was a point-of-care laboratory test that could reliably differentiate bacterial from viral infections. Procalcitonin was first described as a marker for bacterial infection in 1993 (1). It is commonly measured in adults and children in Europe but for reasons that are unknown to me, use of procalcitonin has never caught on in most centres in North America. In this issue, the Cochrane review focuses on the impressive results from trials in adults with respiratory tract infections where clinicians were able to decrease the duration of antibiotic use without compromising outcomes (2). The commentaries by Enarson (3) and Irwin (4) lament the paucity of similar studies in paediatrics. As with adult studies, the best that we can hope for are high quality studies looking at outcomes when procalcitonin is used as part of an algorithm rather than studies that show the sensitivity and specificity of the test, given our crippling inability to determine even in retrospect if infections were bacterial or viral. As an aside, the one potential downside to algorithms that employ biomarkers is that they downplay clinical judgment. Often trainees need to be reminded that biomarkers are just one piece of the puzzle, and that the appearance of the patient should still over-rule the results of investigations. The Eco-Paediatrics page looks at use of corticosteroids for cystic fibrosis (5). Corticosteroids are a temporary fix for almost any condition that involves inflammation, but given their adverse event profile, they are being supplanted by other anti-inflammatory agents for long-term use wherever practical.","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1931","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600565","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":"Inhaled corticosteroids for cystic fibrosis—are they worth the risk?","authors":"Joan Robinson","doi":"10.1002/ebch.1920","DOIUrl":"10.1002/ebch.1920","url":null,"abstract":"<p>Eco-paediatrics is an occasional feature in Evidence-Based Child Health: A Cochrane Review Journal. Our goal is to contribute to the worldwide discussion on reducing waste in health care. In each instalment, we will select a recent Cochrane review highlighting a practice, still in use, which the available evidence tells us should be discontinued.</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600567","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 ‘Interventions for promoting re-integration and reducing harmful behaviour and lifestyles in street-connected children and young people’ with a response from the review authors†","authors":"Rahila U. Christian,&nbsp;Esther Coren,&nbsp;Rosa Hossain","doi":"10.1002/ebch.1924","DOIUrl":"10.1002/ebch.1924","url":null,"abstract":"<p>This is a commentary on a Cochrane review, published in the issue of EBCH, first published as: Coren E, Hossain R, Pardo Pardo J, Veras MMS, Chakraborty K, Harris H, Martin AJ. Interventions for promoting re-integration and reducing harmful behaviour and lifestyles in street-connected children and young people. <i>Cochrane Database of Systematic Reviews</i> 2013, Issue 2. Art. No.: CD009823. DOI: 10.1002/14651858.CD009823.pub2.</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600569","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 ‘Propofol versus thiopental sodium for the treatment of refractory status epilepticus—Still no answer’","authors":"Jeffrey Buchhalter,&nbsp;Antonia Stang","doi":"10.1002/ebch.1930","DOIUrl":"10.1002/ebch.1930","url":null,"abstract":"<p>This is a commentary on a Cochrane review, published in this issue of EBCH, first published as: Prabhakar H, Bindra A, Singh GP, Kalaivani M. Propofol versus thiopental sodium for the treatment of refractory status epilepticus. <i>Cochrane Database of Systematic Reviews</i> 2012, Issue 8. Art. No.: CD009202. DOI: 10.1002/14651858.CD009202.pub2.</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31736698","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":"Response by authors.","authors":"Philipp Schuetz,&nbsp;Matthias Briel,&nbsp;Heiner C Bucher,&nbsp;Beat Mueller","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31736697","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":"Response by authors.","authors":"Esther Coren,&nbsp;Rosa Hossain","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31736696","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":"Commentaries on ‘Home safety education and provision of safety equipment for injury prevention’","authors":"Kelly Russell,&nbsp;Barbara Morrongiello,&nbsp;Kieran J. Phelan","doi":"10.1002/ebch.1912","DOIUrl":"10.1002/ebch.1912","url":null,"abstract":"<p>These are commentaries on a Cochrane review, published in the issue of EBCH, first published as: Kendrick D, Young B, Mason-Jones AJ, Ilyas N, Achana FA, Cooper NJ, Hubbard SJ, Sutton AJ, Smith S, Wynn P, Mulvaney C, Watson MC, Coupland C. Home safety education and provision of safety equipment for injury prevention. <i>Cochrane Database of Systematic Reviews</i> 2012, Issue 9. Art. No.: CD005014. DOI: 10.1002/14651858.CD005014.pub3.</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600420","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":"Home safety education and provision of safety equipment for injury prevention (Review)","authors":"Denise Kendrick,&nbsp;Ben Young,&nbsp;Amanda J Mason-Jones,&nbsp;Nohaid Ilyas,&nbsp;Felix A Achana,&nbsp;Nicola J Cooper,&nbsp;Stephanie J Hubbard,&nbsp;Alex J Sutton,&nbsp;Sherie Smith,&nbsp;Persephone Wynn,&nbsp;Caroline Mulvaney,&nbsp;Michael C Watson,&nbsp;Carol Coupland","doi":"10.1002/ebch.1911","DOIUrl":"10.1002/ebch.1911","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In industrialised countries injuries (including burns, poisoning or drowning) are the leading cause of childhood death and steep social gradients exist in child injury mortality and morbidity. The majority of injuries in pre-school children occur at home but there is little meta-analytic evidence that child home safety interventions reduce injury rates or improve a range of safety practices, and little evidence on their effect by social group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We evaluated the effectiveness of home safety education, with or without the provision of low cost, discounted or free equipment (hereafter referred to as home safety interventions), in reducing child injury rates or increasing home safety practices and whether the effect varied by social group.</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) (2009, Issue 2) in <i>The Cochrane Library</i>, MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED), ISI Web of Science: Social Sciences Citation Index (SSCI), ISI Web of Science: Conference Proceedings Citation Index- Science (CPCI-S), CINAHL (EBSCO) and DARE (2009, Issue 2) in <i>The Cochrane Library</i>. We also searched websites and conference proceedings and searched the bibliographies of relevant studies and previously published reviews. We contacted authors of included studies as well as relevant organisations. The most recent search for trials was May 2009.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>Randomised controlled trials (RCTs), non-randomised controlled trials and controlled before and after (CBA) studies where home safety education with or without the provision of safety equipment was provided to those aged 19 years and under, and which reported injury, safety practices or possession of safety equipment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Two authors independently assessed study quality and extracted data. We attempted to obtain individual participant level data (IPD) for all included studies and summary data and IPD were simultaneously combined in meta-regressions by social and demographic variables. Pooled incidence rate ratios (IRR) were calculated for injuries which occurred during the studies, and pooled odds ratios were calculated for the uptake of safety equipment or safety practices, with 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 ","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1911","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600419","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}