BMJ clinical evidence最新文献_第4页

MRSA colonisation (eradicating colonisation in people without active invasive infection). MRSA 定植（根除无活动性侵袭感染者的定植）。

BMJ clinical evidence Pub Date : 2015-11-13

Suzanne F Bradley

{"title":"MRSA colonisation (eradicating colonisation in people without active invasive infection).","authors":"Suzanne F Bradley","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) contains a gene that makes it resistant to methicillin as well as to other beta-lactam antibiotics, including flucloxacillin, cephalosporins, and carbapenems. MRSA can be part of the normal body flora (colonisation), especially in the nose, but it can cause infection. Until recently, MRSA has primarily been a problem associated with exposure to the healthcare system, especially in people with prolonged hospital admissions or underlying disease, or after antibiotic use. In many countries worldwide, a preponderance of S aureus bloodstream isolates are resistant to methicillin.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatment for MRSA nasal or extra-nasal colonisation in adults? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 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 850 studies. After deduplication and removal of conference abstracts, 356 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 273 studies, and the further review of 83 full publications. Of the 83 full articles evaluated, no studies were added at this update. We performed a GRADE evaluation for three PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for five interventions based on information about the effectiveness and safety of antiseptic body washes, chlorhexidine-neomycin nasal cream, mupirocin nasal ointment, systemic antimicrobials, and other topical antimicrobials.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195262","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

Menière's disease. 梅尼埃病

BMJ clinical evidence Pub Date : 2015-11-05

Tony Wright

{"title":"Menière's disease.","authors":"Tony Wright","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Menière's disease causes feelings of fullness or pressure in the ear, hearing loss, tinnitus, and recurrent bouts of vertigo, and mainly affects people aged 30-60 years. Menière's disease is at first progressive but fluctuating, and episodes can occur in clusters. Vertigo usually resolves eventually, but the hearing deteriorates and the tinnitus and pressure may persist regardless of treatment.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of combination treatment (betahistine plus thiazide diuretic) to prevent attacks and delay disease progression of Menière's disease? What are the effects of intratympanic interventions to prevent attacks and delay disease progression of Menière's disease? What are the effects of non-drug interventions to prevent attacks and delay disease progression of Menière's disease? What are the effects of dietary interventions to prevent attacks and delay disease progression of Menière's disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 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 200 studies. After deduplication and removal of conference abstracts, 151 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 100 studies and the further review of 51 full publications. Of the 51 full articles evaluated, five systematic reviews and four RCTs were added at this update. We performed a GRADE evaluation for eight PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for seven interventions based on information about the effectiveness and safety of betahistine plus thiazide diuretic, caffeine restriction, intratympanic corticosteroids, intratympanic gentamicin, psychological support, salt restriction, and vestibular rehabilitation.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195261","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

Hodgkin's lymphoma (relapsed or refractory): autologous stem cell therapy. 霍奇金淋巴瘤(复发或难治性):自体干细胞治疗。

BMJ clinical evidence Pub Date : 2015-10-26

Amin Rahemtulla, Evangelos Terpos

{"title":"Hodgkin's lymphoma (relapsed or refractory): autologous stem cell therapy.","authors":"Amin Rahemtulla, Evangelos Terpos","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: People with Hodgkin's lymphoma usually present with a lump in the neck or upper chest, but a quarter of people also have fever, sweating, weight loss, fatigue, and itch. Almost all people with localised disease can be cured and, even among people with relapsed advanced disease, almost 50% to 60% survive event-free for 4 years or more. However, a proportion of patients with early Hodgkin's lymphoma with poor prognostic factors (up to 15%) or with advanced disease (40%-50%) still relapses or has refractory disease.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of high-dose chemotherapy plus autologous stem cell therapy for relapsed or refractory Hodgkin's lymphoma? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).Results: Searching of electronic databases retrieved 298 studies. Appraisal of titles and abstracts led to the exclusion of 245 studies and the further review of 53 full publications. Of the 53 full articles evaluated, one systematic review was added. We performed a GRADE evaluation for three PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for one intervention, based on information relating to the effectiveness and safety of high-dose chemotherapy plus autologous stem cell therapy (versus conventional chemotherapy).","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620913/pdf/2015-2404.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34185733","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

Paracetamol (acetaminophen) poisoning. 扑热息痛(醋氨酚)中毒。

BMJ clinical evidence Pub Date : 2015-10-19

B Kevin Park, James W Dear, Daniel J Antoine

{"title":"Paracetamol (acetaminophen) poisoning.","authors":"B Kevin Park, James W Dear, Daniel J Antoine","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Paracetamol directly causes around 150 deaths per year in UK.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatments for acute paracetamol poisoning? 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 127 studies. After deduplication and removal of conference abstracts, 64 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 46 studies and the further review of 18 full publications. Of the 18 full articles evaluated, one systematic review was updated and one RCT was added at this update. In addition, two systematic reviews and three RCTs not meeting our inclusion criteria were added to the Comment sections. We performed a GRADE evaluation for three PICO combinations.Conclusions: In this systematic overview we categorised the efficacy for six interventions, based on information about the effectiveness and safety of activated charcoal (single or multiple dose), gastric lavage, haemodialysis, liver transplant, methionine, and acetylcysteine.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610347/pdf/2015-2101.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34267548","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

Obesity in children: bariatric surgery. 儿童肥胖：减肥手术。

BMJ clinical evidence Pub Date : 2015-10-15

Dexter Canoy, TienYu Owen Yang

{"title":"Obesity in children: bariatric surgery.","authors":"Dexter Canoy, TienYu Owen Yang","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The prevalence of childhood obesity in the UK and in many countries worldwide remains high. Behavioural interventions to modify lifestyle, such as diet and physical activity, usually form part of weight management strategies for obese children. Whether or not surgical interventions are effective and safe in treating childhood obesity is unclear.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of surgical interventions for the treatment of childhood obesity? 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 overview).Results: At this update, after deduplication and removal of conference abstracts, 67 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 19 studies and the further review of 48 full publications. Of the 48 full articles evaluated, two systematic reviews were included at this update.Conclusions: In this systematic overview, we categorised the efficacy for two comparisons based on information about the effectiveness and safety of bariatric surgery versus no intervention and different types of bariatric surgery versus each other.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606917/pdf/2015-0325.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34090323","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

Chronic fatigue syndrome. 慢性疲劳综合症。

BMJ clinical evidence Pub Date : 2015-09-28

Anthony J Cleare, Steven Reid, Trudie Chalder, Matthew Hotopf, Simon Wessely

{"title":"Chronic fatigue syndrome.","authors":"Anthony J Cleare, Steven Reid, Trudie Chalder, Matthew Hotopf, Simon Wessely","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Chronic fatigue syndrome affects between 0.006% and 3% of the population depending on the criteria of definition used, with women being at higher risk than men.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of selected treatments for chronic fatigue syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (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 169 studies. After deduplication and removal of conference abstracts, 86 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 71 studies and the further review of 15 full publications. Of the 15 full articles evaluated, two systematic reviews, one RCT, and one further follow-up report of an RCT were added at this update. We performed a GRADE evaluation for 23 PICO combinations.Conclusions: In this systematic overview, we categorised the effectiveness of four interventions based on information relating to the effectiveness and safety of antidepressants, cognitive behavioural therapy, corticosteroids, and graded exercise therapy.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4585442/pdf/2015-1101.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34043074","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

Cardiovascular medication: improving adherence using prompting mechanisms. 心血管药物:利用提示机制提高依从性。

BMJ clinical evidence Pub Date : 2015-09-21

Liam Glynn, Tom Fahey

{"title":"Cardiovascular medication: improving adherence using prompting mechanisms.","authors":"Liam Glynn, Tom Fahey","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Adherence to medication is generally defined as the extent to which people take medications as prescribed by their healthcare providers. It can be assessed in many ways (e.g., by self-reporting, pill counting, direct observation, electronic monitoring, or by pharmacy records). This overview reports effects of prompting mechanisms on adherence to cardiovascular medications, however adherence has been measured.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of prompting mechanisms to improve adherence to long-term medication for cardiovascular disease in adults? We searched Medline, Embase, The Cochrane Library, and other important databases up to May 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 174 studies. After deduplication and removal of conference abstracts, 80 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 45 studies and the further review of 35 full publications. Of the 35 full articles evaluated, one RCT was added at this update. We performed a GRADE evaluation of seven PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for seven comparisons based on information relating to the effectiveness and safety of prompting mechanisms, alone and in combination with reminder packaging or patient education.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577014/pdf/2015-0220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34020872","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

Menorrhagia. 月经过多。

BMJ clinical evidence Pub Date : 2015-09-18

Kirsten Duckitt

{"title":"Menorrhagia.","authors":"Kirsten Duckitt","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Menorrhagia (also known as heavy menstrual bleeding) limits normal activities, affects quality of life, and causes anaemia in two-thirds of women with objective menorrhagia (loss of 80 mL blood per cycle). Prostaglandin disorders may be associated with idiopathic menorrhagia and with heavy bleeding due to fibroids, adenomyosis, or use of intrauterine devices (IUDs). Fibroids have been found in 10% of women with menorrhagia overall and in 40% of women with severe menorrhagia; but half of women having a hysterectomy for menorrhagia are found to have a normal uterus.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of surgical treatments for menorrhagia? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 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 205 studies. After deduplication and removal of conference abstracts, 102 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 56 studies and the further review of 46 full publications. Of the 46 full articles evaluated, three systematic reviews and five RCTs were added at this update. We performed a GRADE evaluation for 30 PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for three surgical interventions based on information about the effectiveness and safety of dilatation and curettage, endometrial destruction (resection or ablation), and hysterectomy.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574688/pdf/2015-0805.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34185803","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

Constipation: opioid antagonists in people prescribed opioids. 便秘:阿片类拮抗剂在处方阿片类药物的人。

BMJ clinical evidence Pub Date : 2015-09-11

Sam H Ahmedzai, Jason W Boland

{"title":"Constipation: opioid antagonists in people prescribed opioids.","authors":"Sam H Ahmedzai, Jason W Boland","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Constipation is a common adverse effect of opioids. As an example, constipation is reported in 52% of people with advanced malignancy, and this figure rises to 87% in people who are terminally ill and taking opioids. There is no reason to believe that people with chronic non-malignant disease who are prescribed opioids will be any less troubled by this adverse effect.Methods and outcomes: We conducted a systematic overview and aimed to answer the following clinical question: What are the effects of opioid antagonists for constipation in people prescribed opioids? The population we studied included people with any condition, although most studies were in people with cancer pain. We searched Medline, Embase, The Cochrane Library, and other important databases up to May 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 162 studies. After deduplication and removal of conference abstracts, 84 records were screened for inclusion in the review. Appraisal of titles and abstracts led to the exclusion of 47 studies and the further review of 37 full publications. Of the 37 full articles evaluated, two systematic reviews and one RCT were included at this update. We performed a GRADE evaluation for three PICO combinations.Conclusions: In this systematic overview we categorised the efficacy for three interventions based on information relating to the effectiveness of alvimopan, methylnaltrexone, and naloxone.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566814/pdf/2015-2407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33996751","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

Heartburn in pregnancy. 怀孕期间的心痛。

BMJ clinical evidence Pub Date : 2015-09-08

Juan C Vazquez

{"title":"Heartburn in pregnancy.","authors":"Juan C Vazquez","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Heartburn is a common complaint during pregnancy; the incidence is reported to be between 17% and 45%.Methods and outcomes: We conducted a systematic overview and aimed to answer the following clinical question: What are the effects of interventions to prevent or treat heartburn in pregnancy? We searched Medline, Embase, The Cochrane Library, and other important databases up to December 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 80 studies. After deduplication and removal of conference abstracts, 59 records were screened for inclusion in the review. Appraisal of titles and abstracts led to the exclusion of 58 studies and the further review of one full publication. The full article evaluated did not meet our reporting criteria, and thus no new evidence was added at this update. We performed a GRADE evaluation for two PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for six interventions, based on information about the effectiveness and safety of acid-suppressing drugs, antacids with or without alginates, raising the head of the bed, reducing caffeine intake, reducing intake of fatty foods, and reducing the size and frequency of meals.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562453/pdf/2015-1411.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34052769","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