BMJ (Clinical research ed.)最新文献

{"title":"Local treatments for cutaneous warts: systematic review.","authors":"Sam Gibbs, Ian Harvey, Jane Sterling, Rosemary Stark","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the evidence for the efficacy of local treatments for cutaneous warts.</p><p><strong>Methods: </strong>Systematic review of randomised controlled trials.</p><p><strong>Main outcomes measures: </strong>Total clearance of warts and adverse effects such as irritation, pain, and blistering.</p><p><strong>Study selection: </strong>Randomised controlled trials of any local treatment for uncomplicated cutaneous warts. All published and unpublished material was considered, with no restriction on date or language.</p><p><strong>Results: </strong>50 included trials provided generally weak evidence because of poor methods and reporting. The best evidence was for topical treatments containing salicylic acid. Data pooled from six placebo controlled trials showed a cure rate of 75% (144 of 191) in cases compared with 48% (89 of 185) in controls (odds ratio 3.91, 95% confidence interval 2.40 to 6.36). Some evidence for the efficacy of contact immunotherapy was provided by two small trials comparing dinitrochlorobenzene with placebo. Evidence for the efficacy of cryotherapy was limited. No consistent evidence was found for the efficacy of intralesional bleomycin, and only limited evidence was found for the efficacy of topical fluorouracil, intralesional interferons, photodynamic therapy, and pulsed dye laser.</p><p><strong>Conclusions: </strong>Reviewed trials of local treatments for cutaneous warts were highly variable in methods and quality, and there was a paucity of evidence from randomised, placebo controlled trials on which to base the rational use of the treatments. There is good evidence that topical treatments containing salicylic acid have a therapeutic effect and some evidence for the efficacy of dinitrochlorobenzene. Less evidence was found for the efficacy of all the other treatments reviewed, including cryotherapy.</p>","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"325 7362","pages":"461"},"PeriodicalIF":0.0,"publicationDate":"2002-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC119440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133507","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":"The pharmaceutical industry and disease mongering. The industry works to develop drugs, not diseases.","authors":"Richard Tiner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"325 7357","pages":"216; author reply 216"},"PeriodicalIF":0.0,"publicationDate":"2002-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900478","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":"Nurses as NHS gatekeepers. Nurses tend to use social rather than medical model of care.","authors":"Annabelle L Mark","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"325 7356","pages":"165"},"PeriodicalIF":0.0,"publicationDate":"2002-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900475","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":"Detecting patients at a high risk of developing chronic obstructive pulmonary disease in general practice: cross sectional case finding study.","authors":"C P Van Schayck, J M C Loozen, E Wagena, R P Akkermans, G J Wesseling","doi":"10.1136/bmj.324.7350.1370","DOIUrl":"https://doi.org/10.1136/bmj.324.7350.1370","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effectiveness of case finding of patients at risk of developing chronic obstructive pulmonary disease, whether the method is suitable for use in general practice, how patients should be selected, and the time required.</p><p><strong>Design: </strong>Cross sectional study.</p><p><strong>Setting: </strong>Two semirural general practices in the Netherlands.</p><p><strong>Participants: </strong>651 smokers aged 35 to 70 years.</p><p><strong>Main outcome measures: </strong>Short standardised questionnaire on bronchial symptoms for current smokers, lung function with a spirometer, and the quality of the spirometric curve.</p><p><strong>Results: </strong>Of the 201 smokers not taking drugs for a pulmonary condition, 169 produced an acceptable curve (fulfilling American Thoracic Society criteria). Of these, 30 (18%, 95% confidence interval 12% to 24%) had a forced expiratory volume in one second (FEV(1)) <80% of predicted. When smokers were preselected on the basis of chronic cough, the proportion with an FEV(1) <80% of predicted increased to 27% (17 of 64; 12% to 38%). Chronic cough was a better predictor of airflow obstruction than other symptoms, such as wheeze and dyspnoea. The presence of two symptoms was a slightly better predictor than cough only (odds ratio 3.02 (1.37 to 6.64) v 2.50 (1.14 to 5.52)). Age was also a good predictor of obstruction; smokers over 60 with cough had a 48% chance of having an obstruction. The mean time needed for spirometry was four minutes. Detecting one smoker with an FEV(1) <80% of predicted cost 5 pound sterling to 10 pound sterling.</p><p><strong>Conclusions: </strong>Trained practice assistants could check all patients who smoke for chronic obstructive pulmonary disease at little cost to the practice. Cough and age are the most important predictors of the disease. By testing one smoker a day, an average practice could identify one patient at risk a week.</p>","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"324 7350","pages":"1370"},"PeriodicalIF":0.0,"publicationDate":"2002-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC115215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121575","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":"Fortification of flour with folic acid. Fortification has several potential risks.","authors":"Edward Reynolds","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"324 7342","pages":"918"},"PeriodicalIF":0.0,"publicationDate":"2002-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133506","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":"Effectiveness of guidelines on persistent glue ear in children. Authors' estimates of size of impact are probably excessive.","authors":"Nick Black, Andrew Hutchings","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"324 7338","pages":"673"},"PeriodicalIF":0.0,"publicationDate":"2002-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133505","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":"Secondary prevention of coronary heart disease. Ill defined inclusion criteria resulted in missed trials.","authors":"Karen Rees, Shah Ebrahim","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"324 7337","pages":"611"},"PeriodicalIF":0.0,"publicationDate":"2002-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133504","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":"Rapid assessment of chest pain. \"Casualty\" is outdated term for \"emergency medicine\".","authors":"John M Ryan, John Heyworth","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"324 7334","pages":"422"},"PeriodicalIF":0.0,"publicationDate":"2002-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900474","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":"Vaginal delivery after caesarean section. Study's focus on induction v spontaneous labour neglects spontaneous deliver.","authors":"B A Daviss","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"323 7324","pages":"1307"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121801","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":"Racism in medicine. Regional arbitration panel may offer solution.","authors":"B R Pal","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93911,"journal":{"name":"BMJ (Clinical research ed.)","volume":"323 7321","pages":"1125; author reply 1127"},"PeriodicalIF":0.0,"publicationDate":"2001-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900472","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}