BMJ clinical evidence最新文献_第6页

Varicocele. 精索静脉曲张。

BMJ clinical evidence Pub Date : 2015-07-13

Rebecca Macleod, Chandra Shekhar Biyani, Jon Cartledge, Ian Eardley

{"title":"Varicocele.","authors":"Rebecca Macleod, Chandra Shekhar Biyani, Jon Cartledge, Ian Eardley","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Varicocele is estimated to affect about 15% of the general male population. It usually occurs only on the left side, and is often asymptomatic. There is little evidence that varicocele reduces male fertility, although it is found in 12% of male partners of couples presenting with infertility and in 25% of men with abnormal semen analysis.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatments in adult males with varicocele? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (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 203 studies. After deduplication and removal of conference abstracts, 91 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 53 studies and the further review of 38 full publications. Of the 38 full articles evaluated, one existing systematic review was updated and two systematic reviews and five RCTs were added at this update. We performed a GRADE evaluation of nine PICO combinations.Conclusions: In this systematic overview we categorised the efficacy for four interventions, based on information relating to the effectiveness of embolisation, expectant management, sclerotherapy, and surgical ligation.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500994/pdf/2015-1806.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34280314","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

Epilepsy: behavioural, psychological, and ketogenic diet treatments. 癫痫：行为、心理和生酮饮食治疗。

BMJ clinical evidence Pub Date : 2015-07-10

Helen Cross

{"title":"Epilepsy: behavioural, psychological, and ketogenic diet treatments.","authors":"Helen Cross","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: About 3% of people will be diagnosed with epilepsy during their lifetime, but about 70% of people with epilepsy eventually go into remission.Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of behavioural and psychological treatments in people with epilepsy? What are the effects of ketogenic diets in people with epilepsy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version).Results: Searching of electronic databases retrieved 259 studies. After deduplication and removal of conference abstracts, 253 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 208 studies and the further review of 45 full publications. Of the 45 full articles evaluated, six systematic reviews and seven RCTs were included at this update. We performed a GRADE evaluation for six PICO combinations.Conclusions: In this systematic overview we categorised the efficacy for seven interventions, based on information relating to the effectiveness and safety of: biofeedback, cognitive behavioural therapy (CBT), educational programmes, family counselling, ketogenic diet, relaxation therapy (alone or plus behavioural modification therapy), and yoga.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498503/pdf/2015-1214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33996925","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 kidney disease. 慢性肾脏疾病。

BMJ clinical evidence Pub Date : 2015-06-29

Catherine M Clase, Andrew Smyth

{"title":"Chronic kidney disease.","authors":"Catherine M Clase, Andrew Smyth","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Continued progression of kidney disease will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Methods and outcomes: We conducted a systematic review, aiming to answer the following clinical questions: What are the effects of a low-sodium diet to reduce progression rate of chronic kidney disease? What are the effects of a low-protein diet to reduce progression rate of chronic kidney disease? 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: We found seven studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.Conclusions: In this systematic overview we present information relating to the effectiveness and safety of the following interventions: low-protein diet versus control, different low-protein diets versus each other (low-protein diet versus very low-protein diet), low-sodium diet versus control, different low-sodium diets versus each other.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484327/pdf/2015-2004.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33309178","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

Hepatitis C (chronic). 丙型肝炎（慢性）。

BMJ clinical evidence Pub Date : 2015-06-24

Alan Hoi Lun Yau, Vladimir Marquez-Azalgara, Eric M Yoshida

{"title":"Hepatitis C (chronic).","authors":"Alan Hoi Lun Yau, Vladimir Marquez-Azalgara, Eric M Yoshida","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: About 60% to 85% of people infected with hepatitis C virus will go on to develop chronic hepatitis C, which is now believed to affect 3% of the world's population.Methods and outcomes: We conducted a systematic overview and aimed to answer the following clinical questions: What are the effects of interferon-free treatments in treatment-naïve people with chronic hepatitis C infection without cirrhosis? What are the effects of interferon-free treatments in treatment-naïve people with chronic hepatitis C infection with cirrhosis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this review).Results: After deduplication and removal of conference abstracts, 30 records were screened for inclusion in the review. Appraisal of titles and abstracts led to the exclusion of 11 studies and the further review of 19 full publications. Of the 19 full articles evaluated, two systematic reviews and one RCT were added. We performed a GRADE evaluation for two PICO combinations.Conclusions: In this systematic overview, we categorised the efficacy for 12 different intervention/comparison combinations, based on information relating to the effectiveness and safety of sofosbuvir (with or without ribavirin), sofosbuvir (with or without ribavirin) plus ledipasvir, and sofosbuvir (with or without ribavirin) plus simeprevir, all in people with and without cirrhosis.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4479184/pdf/2015-0921.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33417548","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

Tubal ectopic pregnancy. 输卵管异位妊娠。

BMJ clinical evidence Pub Date : 2015-06-18 DOI: 10.53347/rid-36812

R. Varma, J. Gupta

{"title":"Tubal ectopic pregnancy.","authors":"R. Varma, J. Gupta","doi":"10.53347/rid-36812","DOIUrl":"https://doi.org/10.53347/rid-36812","url":null,"abstract":"INTRODUCTION\u0000Approximately 1/100 pregnancies are ectopic, with the conceptus usually implanting in the fallopian tube. Some ectopic pregnancies resolve spontaneously, but others continue to grow and lead to rupture of the tube. Risks are higher in women with damage to the fallopian tubes due to pelvic infections, surgery, or previous ectopic pregnancy.\u0000\u0000\u0000METHODS AND OUTCOMES\u0000We conducted a systematic review and aimed to answer the following clinical question: What treatments improve outcomes in women with unruptured tubal ectopic pregnancy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). The authors also separately searched Medline and Pubmed up to May 2008 in addition to the Clinical Evidence systematic search to support the comments and clinical guide sections.\u0000\u0000\u0000RESULTS\u0000We found 47 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.\u0000\u0000\u0000CONCLUSIONS\u0000In this systematic review we present information relating to the effectiveness and safety of the following interventions: salpingotomy, salpingectomy, systemic methotrexate, systemic methotrexate following salpingotomy, and expectant management.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83141397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 35

Otitis externa. 外耳炎。

BMJ clinical evidence Pub Date : 2015-06-15

Daniel Hajioff, Samuel MacKeith

{"title":"Otitis externa.","authors":"Daniel Hajioff, Samuel MacKeith","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Otitis externa is thought to affect 10% of people at some stage, and can present in acute, chronic, or necrotising forms. Otitis externa may be associated with eczema of the ear canal, and is more common in swimmers, in humid environments, in people with narrow ear canals, in hearing-aid users, and after mechanical trauma.Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of empirical treatments for otitis externa? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).Results: Nine studies were included. We performed a GRADE evaluation of the quality of evidence for interventions.Conclusions: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: oral antibiotics, specialist aural toilet, topical acetic acid, topical aluminium acetate, topical antibacterials, topical antifungals, topical corticosteroids, and combinations of these agents.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466798/pdf/2015-0510.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33389149","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

Chickenpox: treatment. 水痘：治疗。

BMJ clinical evidence Pub Date : 2015-06-15

Jonathan Cohen, Judith Breuer

{"title":"Chickenpox: treatment.","authors":"Jonathan Cohen, Judith Breuer","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Chickenpox is extremely contagious. More than 90% of unvaccinated people will become infected during their lifetime, but infection occurs at different ages in different parts of the world. In the US, the UK, and Japan, more than 80% of people have been infected by the age of 10 years, and by the age of 20 to 30 years in India, South East Asia, and the West Indies. It is usually a mild and self-limiting disease, but it can be severely complicated by pneumonitis or disseminated disease in some individuals, particularly neonates and those who are immunocompromised.Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatment for chickenpox in healthy adults and children (including neonates) within 24 hours after onset of rash? What are the effects of treatment for chickenpox in healthy adults and children (including neonates) later than 24 hours after onset of rash? What are the effects of treatment for chickenpox in immunocompromised adults and children (including neonates)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).Results: We found six studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.Conclusions: In this systematic overview we present information relating to the effectiveness and safety of aciclovir, within 24 hours of onset of rash or later than 24 hours of onset of rash, in otherwise-healthy adults and children (including neonates); and aciclovir in immunocompromised adults and children (including neonates).","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468609/pdf/2015-0912.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33388988","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

Urinary tract infection in children: recurrent infections. 儿童尿路感染:反复感染。

BMJ clinical evidence Pub Date : 2015-06-12

James Larcombe

引用次数: 0

Endometriosis: the effects of dienogest. 子宫内膜异位症：迪诺吉斯特的影响。

BMJ clinical evidence Pub Date : 2015-06-09

Simone Ferrero, Valentino Remorgida, Pier Luigi Venturini, Nicolò Bizzarri

{"title":"Endometriosis: the effects of dienogest.","authors":"Simone Ferrero, Valentino Remorgida, Pier Luigi Venturini, Nicolò Bizzarri","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Ectopic endometrial tissue is found in 2% to 6% of women of reproductive age, in up to 60% of those with dysmenorrhoea, and in up to 30% of women with subfertility, with a peak incidence at around 40 years of age. However, symptoms may not correlate with laparoscopic findings.Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of dienogest for the treatment of endometriosis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).Results: Five studies were included. We performed a GRADE evaluation of the quality of evidence for interventions.Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: dienogest versus placebo or no treatment; dienogest versus gonadorelin analogues; dienogest versus combined oral contraceptives; dienogest versus other progestogens.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461025/pdf/2015-0802.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33371467","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

Migraine headache in children. 儿童偏头痛。

BMJ clinical evidence Pub Date : 2015-06-05

Nick Peter Barnes

{"title":"Migraine headache in children.","authors":"Nick Peter Barnes","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Diagnosis of migraine headache in children can be difficult as it depends on subjective symptoms; diagnostic criteria are broader than in adults. Migraine occurs in 3% to 10% of children and increases with age up to puberty. Migraine spontaneously remits after puberty in half of children, but if it begins during adolescence it may be more likely to persist throughout adulthood.Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute attacks of migraine headache in children? What are the effects of pharmacological prophylaxis for migraine headache in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).Results: Twenty-three studies were included. We performed a GRADE evaluation of the quality of evidence for interventions.Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions. For acute symptom relief: 5HT1 agonists [such as triptans], non-steroidal anti-inflammatory drugs [NSAIDs], and paracetamol. And, for prophylaxis: beta-blockers, flunarizine, pizotifen, and topiramate.","PeriodicalId":72432,"journal":{"name":"BMJ clinical evidence","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456852/pdf/2015-0318.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33236236","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