BMJ clinical evidence最新文献_第3页

BMJ clinical evidence Pub Date : 2016-01-22

Martin M Meremikwu, Uduak Okomo

{"title":"Sickle cell disease.","authors":"Martin M Meremikwu, Uduak Okomo","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Sickle cell disease causes chronic haemolytic anaemia, dactylitis, and painful acute crises. It also increases the risk of stroke, organ damage, bacterial infections, and complications of blood transfusion. In sub-Saharan Africa, up to one third of adults are carriers of the defective sickle cell gene, and 1% to 2% of babies are born with the disease.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of pharmaceutical interventions to prevent sickle cell crisis and other acute complications in people with sickle cell disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2015 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 369 studies. After deduplication and removal of conference abstracts, 136 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 99 studies and the further review of 37 full publications. Of the 37 full articles evaluated, three already included systematic reviews were updated, two systematic reviews, two RCTs, and one subsequent RCT were added at this update. We performed a GRADE evaluation for 12 PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for five interventions based on information about the effectiveness and safety of antibiotic prophylaxis in children aged under 5 years, antibiotic prophylaxis in children aged 5 years or older, hydroxyurea, malaria chemoprophylaxis, and pneumococcal vaccines.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195266","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}

引用次数: 0

Malignant melanoma (non-metastatic): sentinel lymph node biopsy. 恶性黑色素瘤（非转移性）：前哨淋巴结活检。

BMJ clinical evidence Pub Date : 2016-01-19

Andy Pay

{"title":"Malignant melanoma (non-metastatic): sentinel lymph node biopsy.","authors":"Andy Pay","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The incidence of malignant melanoma has increased over the past 25 years in the UK, but death rates have remained fairly constant. The 5-year survival rate ranges from 20% to 95%, depending on disease stage. Risks are greater in white populations and in people with higher numbers of skin naevi.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What is the evidence for performing a sentinel lymph node biopsy in people with malignant melanoma with clinically uninvolved lymph nodes? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 221 studies. After deduplication and removal of conference abstracts, 99 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 58 studies and the further review of 41 full publications. Of the 41 full articles evaluated, one systematic review and three RCTs were added at this update. We performed a GRADE evaluation for two PICO combinations.Conclusions: In this systematic overview, we evaluated the evidence for performing sentinel lymph node biopsy in people with malignant melanoma with clinically uninvolved lymph nodes.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72212180","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}

引用次数: 0

Venous leg ulcers. 腿部静脉溃疡

BMJ clinical evidence Pub Date : 2016-01-15

E Andrea Nelson, Una Adderley

{"title":"Venous leg ulcers.","authors":"E Andrea Nelson, Una Adderley","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0 in 1000 people have active leg ulcers. Prevalence increases with age to about 20 in 1000 people aged over 80 years.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of treatments for venous leg ulcers? What are the effects of organisational interventions for venous leg ulcers? What are the effects of advice about self-help interventions in people receiving usual care for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 116 studies. After deduplication and removal of conference abstracts, 63 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 43 studies and the further review of 20 full publications. Of the 20 full articles evaluated, four systematic reviews were updated and four RCTs were added at this update. We performed a GRADE evaluation for 23 PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for 13 interventions based on information about the effectiveness and safety of advice to elevate leg, advice to keep leg active, compression stockings for prevention of recurrence, compression bandages and stockings to treat venous leg ulcers, laser treatment (low level), leg ulcer clinics, pentoxifylline, skin grafting, superficial vein surgery for prevention of recurrence, superficial vein surgery to treat venous leg ulcers, therapeutic ultrasound, and topical negative pressure.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195267","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}

引用次数: 0

Generalised anxiety disorder in children and adolescents. 儿童和青少年的广泛性焦虑症。

BMJ clinical evidence Pub Date : 2016-01-13

Christopher K Gale, Jane Millichamp

{"title":"Generalised anxiety disorder in children and adolescents.","authors":"Christopher K Gale, Jane Millichamp","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Generalised anxiety disorder (GAD) in a child or adolescent is excessive worry and tension about everyday events that the child or adolescent cannot control and that is expressed on most days for at least 6 months, to the extent that there is distress or difficulty in performing day-to-day tasks.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of pharmacological treatments for generalised anxiety disorder in children and adolescents? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).Results: At this update, searching of electronic databases retrieved 949 studies. After deduplication and removal of conference abstracts, 417 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 310 studies and the further review of 107 full publications. Of the 107 full articles evaluated, one systematic review was added at this update. We performed a GRADE evaluation for six PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for six interventions based on information about the effectiveness and safety of antidepressants, antipsychotics, benzodiazepines, buspirone, hydroxyzine, and pregabalin.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509806","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}

引用次数: 0

Asthma in adults (acute): magnesium sulfate treatment. 成人哮喘（急性）：硫酸镁治疗。

BMJ clinical evidence Pub Date : 2016-01-13

Ruth H Green

{"title":"Asthma in adults (acute): magnesium sulfate treatment.","authors":"Ruth H Green","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: About 10% of adults have suffered an attack of asthma, and up to 5% of these have severe disease that responds poorly to treatment. Patients with severe disease have an increased risk of death, but patients with mild to moderate disease are also at risk of exacerbations. Most guidelines about the management of asthma follow stepwise protocols. This overview does not endorse or follow any particular protocol, but presents the evidence about a specific intervention, magnesium sulfate.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of magnesium sulfate for acute asthma? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 50 studies. After deduplication and removal of conference abstracts, 24 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 10 studies and the further review of 14 full publications. Of the 14 full articles evaluated, one systematic review was updated and one systematic review was added at this update. We performed a GRADE evaluation for five PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for two comparisons based on information about the effectiveness and safety of magnesium sulfate (iv) versus placebo and magnesium sulfate (nebulised) plus short-acting beta2 agonists (inhaled) versus short-acting beta2 agonists (inhaled) alone.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195263","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}

引用次数: 0

Burning mouth syndrome. 灼口综合征。

BMJ clinical evidence Pub Date : 2016-01-07

Joanna Zakrzewska, John A G Buchanan

{"title":"Burning mouth syndrome.","authors":"Joanna Zakrzewska, John A G Buchanan","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Burning mouth syndrome mainly affects women, particularly after the menopause, when its prevalence may be 18% to 33%.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of selected treatments for burning mouth syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2015 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 70 studies. After deduplication and removal of conference abstracts, 45 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 25 studies and the further review of 20 full publications. Of the 20 full articles evaluated, one systematic review and nine RCTs were added at this update. We performed a GRADE evaluation for five PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for six interventions based on information about the effectiveness and safety of alphalipoic acid, benzodiazepines, benzydamine hydrochloride, cognitive behavioural therapy (CBT), selective serotonin re-uptake inhibitors (SSRIs), and tricyclic antidepressants.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4704679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71435007","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}

引用次数: 0

Primary prevention of CVD: modification of diet in people with hypertension. 心血管疾病的一级预防：调整高血压患者的饮食。

BMJ clinical evidence Pub Date : 2016-01-05

Raj Padwal, Daniel Hackam, Nadia Khan, Sheldon Tobe

{"title":"Primary prevention of CVD: modification of diet in people with hypertension.","authors":"Raj Padwal, Daniel Hackam, Nadia Khan, Sheldon Tobe","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Hypertension (persistent diastolic blood pressure of 90 mmHg or greater or systolic blood pressure 140 mmHg or greater) affects 20% to 35% of the world's adult population and increases the risk of cardiovascular disease, end-stage renal disease, and mortality.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of selected dietary modification for people with hypertension? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 669 studies. After deduplication and removal of conference abstracts, 464 records were screened for inclusion in this overview. Appraisal of titles and abstracts led to the exclusion of 376 studies and the further review of 88 full publications. Of the 88 full articles evaluated, three systematic reviews and three RCTs were added. We performed a GRADE evaluation for eight PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for five interventions based on information about the effectiveness and safety of calcium supplements, a low-salt diet (including the DASH diet), magnesium supplements, a Mediterranean diet, and potassium supplements.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195265","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}

引用次数: 0

Amblyopia in children (aged 7 years or less). 儿童弱视（7 岁或以下）。

BMJ clinical evidence Pub Date : 2016-01-05

Stephanie West, Cathy Williams

{"title":"Amblyopia in children (aged 7 years or less).","authors":"Stephanie West, Cathy Williams","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Amblyopia is reduced visual acuity not immediately correctable by glasses, in the absence of ocular pathology. It is commonly associated with squint (strabismus) or refractive errors resulting in different visual inputs to each eye during the sensitive period of visual development (aged <7-8 years). The cumulative incidence is estimated at 2% to 4% in children aged up to 7 years.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of medical treatments for amblyopia in children aged 7 years or less? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 70 studies. After deduplication and removal of conference abstracts, 51 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 37 studies and the further review of 14 full publications. Of the 14 full articles evaluated, two systematic reviews were updated and three RCTs and two follow-up studies were added at this update. We performed a GRADE evaluation for nine PICO combinations.Conclusions: In this systematic overview we categorised the efficacy for three interventions, based on information about the effectiveness and safety of glasses, occlusion, or penalisation with atropine.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2016 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195422","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}

引用次数: 0

Sickle cell disease. 镰状细胞病。

BMJ clinical evidence Pub Date : 2016-01-01 DOI: 10.1007/978-1-4614-1037-9_215

M. Meremikwu, U. Okomo

引用次数: 3

Cardiorespiratory arrest in children (out of hospital). 儿童心肺骤停（医院外）。

BMJ clinical evidence Pub Date : 2015-12-18

Kristina Krmpotic, Hilary Writer

{"title":"Cardiorespiratory arrest in children (out of hospital).","authors":"Kristina Krmpotic, Hilary Writer","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children per year in resource-rich countries, with two-thirds of arrests occurring in children under 18 months of age. Approximately 45% of cases have undetermined causes, including sudden infant death syndrome. Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatments for non-submersion out-of-hospital cardiorespiratory arrest in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: At this update, searching of electronic databases retrieved 192 studies. After deduplication and removal of conference abstracts, 81 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 68 studies and the further review of 13 full publications. Of the 13 full articles evaluated, three systematic reviews were added at this update. We have also added eight studies to the Comment section. We performed a GRADE evaluation for three PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for nine interventions based on information about the effectiveness and safety of airway management and ventilation (bag-mask ventilation and intubation), bystander cardiopulmonary resuscitation, direct-current cardiac shock, high dose and standard dose intravenous adrenaline (epinephrine), intravenous sodium bicarbonate, intubation versus bag-mask ventilation, targeted temperature management, and training parents to perform resuscitation.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":"2015 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195135","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}

引用次数: 0