MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'NeLM - Disease Focused Reviews' source. Thu, 09 Feb 2012 09:15:15 +0100 http://www.medworm.com/index.php?rid=5654546&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-pregnant-women-with-hyperglycaemia-not-meeting-gestational-diabetes-and-type-2-diabetes-diagnostic-criteria%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Pregnancy hyperglycaemia without meeting gestational diabetes mellitus (GDM) diagnostic criteria affects a significant proportion of pregnant women each year. It is associated with a range of adverse pregnancy outcomes. Although intensive management for women with GDM has been proven beneficial for women and their babies, there is little known about the effects of treating women with hyperglycaemia who do not meet diagnostic criteria for GDM and type 2 diabetes (T2DM).   Objectives To assess the effects of different types of management strategies for pregnant women with hyperglycaemia not meeting diagnostic criteria for GDM and T2DM (referred as borderline GDM in this review).   Search ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5654546 Wed, 01 Feb 2012 05:00:00 +0100 5654546 http://www.medworm.com/index.php?rid=5654545&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-smoking-cessation-in-Indigenous-populations%2F Source: Cochrane Area: Evidence > Disease Focused Reviews Background Tobacco use in Indigenous populations (people who have inhabited a country for thousands of years) is often double that of the non-Indigenous population. A disproportionate burden of substance-related morbidity and mortality exists as a result.   Objectives To evaluate the effectiveness of smoking cessation interventions in Indigenous populations and to summarise these approaches for future cessation programmes and research.   Search methods The Cochrane Tobacco Addiction Group Specialised Register of Trials was searched (April 2011), with additional searches of MEDLINE (May 2011). Online clinical trial databases and publication references were also searched for potential studies.   ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5654545 Wed, 01 Feb 2012 05:00:00 +0100 5654545 http://www.medworm.com/index.php?rid=5654544&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPain-management-for-inflammatory-arthritis-rheumatoid-arthritis-psoriatic-arthritis-ankylosing-spondylitis-and-other-spondylarthritis%2F Source: Cochrane Area: Evidence > Disease Focused Reviews Background Even with optimal disease-modifying treatment and good control of disease activity, persistent pain due to structural damage is common in people with inflammatory arthritis and therefore additional treatment for pain might be required. Because comorbidity is highly prevalent in people with inflammatory arthritis, it is important to consider comorbidities such as gastrointestinal or liver diseases in deciding upon optimal pharmacologic pain therapy.     Objectives To assess the efficacy and safety of pharmacological pain treatment in patients with inflammatory arthritis who have gastrointestinal or liver comorbidities, or both.     Search methods We searched MEDLINE, EMBASE... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5654544 Wed, 01 Feb 2012 05:00:00 +0100 5654544 http://www.medworm.com/index.php?rid=5654543&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTopical-treatments-for-HIV-related-oral-ulcers%2F Source: Cochrane Area: Evidence > Disease Focused Reviews Background In HIV-infected adults, oral ulcers occur more frequently, last longer and produce more painful symptoms than in immunocompetent people. Oral aphthous ulcers observed during the course of HIV infection may be severe and can result in significant morbidity in these patients. Such manifestations may interfere with oral functions and alter patients' quality of life.   Objectives To evaluate the efficacy and side effects of topical agents used in the treatment of HIV-related oral aphthous ulcers in adults.   Search methods The following electronic databases were searched from the year 1980 to May 2011 for randomised controlled trials involving managements of oral ulcers, apthouses in HIV infecte... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5654543 Wed, 01 Feb 2012 05:00:00 +0100 5654543 http://www.medworm.com/index.php?rid=5654542&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FHigh-dose-therapy-with-autologous-stem-cell-transplantation-versus-chemotherapy-or-immuno-chemotherapy-for-follicular-lymphoma-in-adults%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Follicular lymphoma (FL) is the most common indolent and second most common Non-Hodgkin`s lymphoma (NHL) in the Western world. Standard treatment usually includes rituximab and chemotherapy. High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is an option for patients in advanced stages or for second-line therapy, leading to improved progression-free survival (PFS) rates. However, the impact of HDT and ASCT remains unclear, as there are hints of an increased risk of second cancers.     Objectives We performed a systematic review with meta-analysis of randomised controlled trials (RCTs) comparing HDT plus ASCT with chemotherapy or immuno-chemotherapy in patien... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5654542 Wed, 01 Feb 2012 05:00:00 +0100 5654542 http://www.medworm.com/index.php?rid=5590766&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDTB-reviews-herbal-medicines-for-osteoarthritis-%2F This article in the Drug and Therapeutics Bulletin (DTB) reviews the available evidence on the safety and efficacy of herbal medicines for osteoarthritis, including avocado/soybean unsaponifiables, Cat's claw, Devil's claw, Indian frankincense, ginger, nettle, rosehip, turmeric and willow bark.   The authors note that herbal medicinal products have traditionally been used for the relief of osteoarthritis symptoms; however there is a lack of licensed herbal medicinal products for such symptoms and none are specifically licensed for osteoarthritis.    Although some efficacy is suggested for products containing avocado/soybean unsaponifiables, Indian frankincense or rosehip, more robust data are needed.  Several herbal medicinal products containing devil's claw hav... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5590766 Fri, 13 Jan 2012 05:00:00 +0100 5590766 http://www.medworm.com/index.php?rid=5556018&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSclerotherapy-for-lower-limb-telangiectasias%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Sclerotherapy has been used in clinical practice for centuries, but there is still no consensus about which, if any, sclerosing agent provides the best results.   Objectives To assess the effectiveness and safety of sclerosing agents in the treatment of telangiectasias of the lower limbs.     Search methods The Cochrane Peripheral Vascular Diseases (PVD) Group searched their Specialised Register (last searched 26 May 2011) and CENTRAL (2011, Issue 2). We searched references within identified studies and from the Cited References in the Web of Science. We contacted study authors and pharmaceutical companies. There were no language restrictions.     Selection... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5556018 Sun, 01 Jan 2012 05:00:00 +0100 5556018 http://www.medworm.com/index.php?rid=5556017&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FStatins-for-primary-prevention-of-venous-thromboembolism%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Venous thromboembolism (VTE) is common in clinical practice. The efficacy of statins in the primary prevention of VTE remains unproven.   Objectives To assess the efficacy of statins in the primary prevention of VTE.     Search methods The Cochrane Peripheral Vascular Diseases (PVD) Group searched their Specialised Register (last searched April 2011) and CENTRAL (2011, Issue 2). The authors searched MEDLINE (January 1966 to March 2011); EMBASE (1974 to March 2011); ISI Web of Knowledge (2001 to March 2011); the Chinese Biomedical Literature Database (1978 to March 2011) and other resources (including clinical trials registers, reference lists and presentations at various confer... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5556017 Sun, 01 Jan 2012 05:00:00 +0100 5556017 http://www.medworm.com/index.php?rid=5556016&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSupport-surfaces-for-treating-pressure-ulcers%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Pressure ulcers are treated by reducing pressure on the areas of damaged skin. Special support surfaces (including beds, mattresses and cushions) designed to redistribute pressure, are widely used as treatments. The relative effects of different support surfaces are unclear.   Objectives To assess the effects of pressure-relieving support surfaces in the treatment of pressure ulcers.     Search methods We searched: The Cochrane Wounds Group Specialised Register (searched 15 July 2011); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3); Ovid MEDLINE (2007 to July Week 1 2011); Ovid MEDLINE (In-Process & Other Non-Indexed Cita... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5556016 Sun, 01 Jan 2012 05:00:00 +0100 5556016 http://www.medworm.com/index.php?rid=5556015&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTiming-of-prophylactic-antibiotics-for-preventing-postpartum-infectious-morbidity-in-women-undergoing-cesarean-delivery%2F The objectives are as follows: To assess the effects of antibiotics given prior to skin incision compared with administration after cord clamping in newborns and women undergoing caesarean section.   (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5556015 Sun, 01 Jan 2012 05:00:00 +0100 5556015 http://www.medworm.com/index.php?rid=5556014&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTopical-interventions-for-genital-lichen-sclerosus%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Lichen sclerosus is a chronic, inflammatory skin condition that most commonly occurs in adult women, although it may also be seen in men and children. It primarily affects the genital area and around the anus, where it causes persistent itching and soreness. Scarring after inflammation may lead to severe damage by fusion of the vulval lips (labia); narrowing of the vaginal opening; and burying of the clitoris in women and girls, as well as tightening of the foreskin in men and boys, if treatments are not started early. Affected people have an increased risk of genital cancers.   Objectives To assess the effects of topical interventions for genital lichen sclerosus and adverse effects reported in... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5556014 Sun, 01 Jan 2012 05:00:00 +0100 5556014 http://www.medworm.com/index.php?rid=5415414&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAnti-hypertensive-drugs-as-disease-modifying-agents-for-Parkinsons-disease-evidence-from-observational-studies-and-clinical-trials%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Current treatment for Parkinson's disease (PD) is focused on relieving symptoms, at present there is nothing that is widely accepted to halt or slow disease progression. Potential neuroprotective or disease modifying agents have been identified from preclinical studies. One such group of compounds are anti-hypertensive drugs.   Objectives 1) Do anti-hypertensive drugs prevent the onset of PD? (primary prevention) 2) Are anti-hypertensive drugs disease modifying agents in PD, do they slow the progression of disease once PD is established? (secondary prevention) 3) What are the adverse effects of taking anti-hypertensive drugs for patients with PD?   Search strategy Electronic dat... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5415414 Thu, 17 Nov 2011 05:00:00 +0100 5415414 http://www.medworm.com/index.php?rid=5415413&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FHelicobacter-pylori-eradication-for-Parkinsons-disease%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Levodopa is the mainstay of treatment for alleviating the motor symptoms associated with Parkinson's disease. However, patients often experience fluctuations in their symptoms over time and 'wearing off' which may be partly related to variable absorption of the drug. There is some evidence that treatment of the common gastrointestinal infection Helicobacter pylori (H pylori) with antibiotics may improve levodopa absorption in the gut and hence improve symptoms.   Objectives 1)  What is the prevalence of H pylori in Parkinson's disease patients? 2)  Does treatment of H pylori infection with antibiotics improve symptoms in Parkinson's disease patients? Is this effect dependent on improve... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5415413 Thu, 17 Nov 2011 05:00:00 +0100 5415413 http://www.medworm.com/index.php?rid=5415412&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FNon-steroidal-anti-inflammatory-drugs-as-disease-modifying-agents-for-Parkinsons-disease-evidence-from-observational-studies%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Neuroinflammation may play a key role in the neurodegeneration associated with Parkinson's disease (PD). Non-steroidal anti-inflammatory drugs (NSAIDs) may be beneficial in the primary and secondary prevention of PD.   Objectives 1) Do NSAIDs prevent the onset of PD? 2) Are NSAIDs neuroprotective in PD - do they slow the progression of disease once PD is established? 3) What are the adverse effects of taking NSAIDs in PD?   Search strategy We searched electronic databases, including trial registers, complemented with handsearching of conference proceedings and citation searching on key articles. All searching was updated in May 2011. We contacted authors to provide additional in... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5415412 Thu, 17 Nov 2011 05:00:00 +0100 5415412 http://www.medworm.com/index.php?rid=5415411&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPharmacological-interventions-for-the-treatment-of-anxiety-disorders-in-chronic-obstructive-pulmonary-disease%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Chronic Obstructive Pulmonary Disease (COPD) is characterised by inflammation of the airways and destruction of pulmonary tissue with post bronchodilator FEV1/FVC of <0.70 (forced expiratory volume in one second/forced vital capacity). Evidence indicates an increased prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease (COPD), as compared with the general population and persons suffering from many other chronic illnesses. Anxiety in people with COPD has been shown to increase disability and impair functional status, resulting in an overall reduction in quality of life. As such, pharmacological interventions are commonly used to treat anxiety disorders in patients with C... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5415411 Thu, 17 Nov 2011 05:00:00 +0100 5415411 http://www.medworm.com/index.php?rid=5415410&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FXylitol-for-preventing-acute-otitis-media-in-children-up-to-12-years-of-age%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Acute otitis media (AOM) is the most common bacterial infection among young children in the United States with limitations and concerns over its treatment with antibiotics and surgery. Therefore, effective preventative measures are attractive. A potential preventative measure is xylitol, a natural sugar substitute that reduces the risk for dental decay. Xylitol can reduce the adherence of Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) to nasopharyngeal cells in vitro.   Objectives To assess the efficacy and safety of xylitol to prevent AOM in children up to 12 years old.   Search strategy We searched the Cochrane Central Register of Controlled T... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5415410 Thu, 17 Nov 2011 05:00:00 +0100 5415410 http://www.medworm.com/index.php?rid=5341971&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FIntermittent-preventive-treatment-regimens-for-malaria-in-HIV-positive-pregnant-women%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Intermittent preventive treatment is recommended for pregnant women living in malaria endemic countries due to benefits for both mother and baby. However, the impact may not be the same in HIV-positive pregnant women, as HIV infection impairs a woman's immunity.     Objectives To compare intermittent preventive treatment regimens for malaria in HIV-positive pregnant women living in malaria-endemic areas.     Search strategy In June 2011, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE; EMBASE; LILACS, the metaRegister of Controlled Trials (mRCT), reference lists and conference abstracts. We also contacted researchers and organizatio... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5341971 Thu, 20 Oct 2011 04:00:00 +0100 5341971 http://www.medworm.com/index.php?rid=5341970&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-disorders-of-eye-movement-in-patients-with-stroke%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Eye movement disorders may affect over 70% of stroke patients. These eye movement disorders can result in difficulty maintaining the normal ocular position and difficulty moving the eyes appropriately. The resulting functional disabilities include a loss of depth perception, reduced hand-to-eye co-ordination, marked difficulties with near tasks and reading and reduced ability to scan the visual environment. They can also impact on the effectiveness of rehabilitation therapy. There are a wide variety of different treatment interventions proposed for eye movement disorders after stroke. However, in the past, there has been a lack of evidence specific to the impact of interventions on the functional outcome of pat... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5341970 Thu, 20 Oct 2011 04:00:00 +0100 5341970 http://www.medworm.com/index.php?rid=5341969&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-visual-field-defects-in-patients-with-stroke%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Visual field defects are estimated to affect 20% to 57% of people who have had a stroke. Visual field defects can affect functional ability in activities of daily living (commonly affecting mobility, reading and driving), quality of life, ability to participate in rehabilitation, and depression, anxiety and social isolation following stroke. There are many interventions for visual field defects, which are proposed to work by restoring the visual field (restitution); compensating for the visual field defect by changing behaviour or activity (compensation); substituting for the visual field defect by using a device or extraneous modification (substitution); or ensuring appropriate diagnosis, referral and treatmen... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5341969 Thu, 20 Oct 2011 04:00:00 +0100 5341969 http://www.medworm.com/index.php?rid=5341968&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FStatins-for-women-with-polycystic-ovary-syndrome-not-actively-trying-to-conceive%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Statins, as lipid-lowering agents with pleiotropic actions, are likely not only to improve the dyslipidaemia associated with polycystic ovary syndrome but may also exert other beneficial metabolic and endocrine effects.   Objectives To assess the efficacy and safety of statin therapy for women with polycystic ovary syndrome (PCOS) who are not actively trying to conceive.     Search strategy We searched the following databases (from inception to week 1, July 2011): the Cochrane Menstrual Disorders and Subfertility Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE and CINAHL. We handsearched relevant conferen... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5341968 Thu, 20 Oct 2011 04:00:00 +0100 5341968 http://www.medworm.com/index.php?rid=5256088&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FMedical-interventions-for-treating-anthracycline-induced-symptomatic-and-asymptomatic-cardiotoxicity-during-and-after-treatment-for-childhood-cancer%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Anthracyclines are frequently used chemotherapeutic agents for childhood cancer that can cause cardiotoxicity during and after treatment. Although several medical interventions in adults with symptomatic or asymptomatic cardiac dysfunction due to other causes are beneficial, it is not known if the same treatments are effective for childhood cancer patients and survivors with anthracycline-induced cardiotoxicity.   Objectives To compare the effect of medical interventions on anthracycline-induced cardiotoxicity in childhood cancer patients or survivors with the effect of placebo, other medical interventions or no treatment.   Search strategy We searched the Cochrane Central Register of Con... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5256088 Mon, 26 Sep 2011 04:00:00 +0100 5256088 http://www.medworm.com/index.php?rid=5256087&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPsychological-and-pharmacological-interventions-for-depression-in-patients-with-coronary-artery-disease%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Depression occurs frequently in patients with coronary artery disease (CAD) and is associated with a poor prognosis.   Objectives To determine the effects of psychological and pharmacological interventions for depression in CAD patients with comorbid depression.   Search strategy CENTRAL, DARE, HTA and EED on The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, ISRCTN Register and CardioSource Registry were searched. Reference lists of included randomised controlled trials (RCTs) were examined and primary authors contacted. No language restrictions were applied.   Selection criteria RCTs investigating psychological and pharmacological interventions for depression in adult... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5256087 Mon, 26 Sep 2011 04:00:00 +0100 5256087 http://www.medworm.com/index.php?rid=5256086&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSingle-dose-oral-analgesics-for-acute-postoperative-pain-in-adults%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Thirty-five Cochrane Reviews of randomised trials testing the analgesic efficacy of individual drug interventions in acute postoperative pain have been published. This overview brings together the results of all those reviews and assesses the reliability of available data.   Objectives To summarise data from all Cochrane Reviews that have assessed the effects of pharmaceutical interventions for acute pain in adults with at least moderate pain following surgery, who have been given a single dose of oral analgesic taken alone.   Methods We identified systematic reviews in The Cochrane Library through a simple search strategy. All reviews were overseen by a single Review Group, had a standa... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5256086 Mon, 26 Sep 2011 04:00:00 +0100 5256086 http://www.medworm.com/index.php?rid=5231188&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSequential-therapy-for-H-pylori-eradication-%2F Source: Drug and Therapeutics Bulletin (DTB) Area: Evidence > Disease Focused Reviews This review in the Drug and Therapeutics Bulletin (DTB) assesses the efficacy and safety of sequential H. pylori eradication therapy. It found that:   Sequential therapy, typically comprising a proton pump inhibitor (PPI) plus amoxicillin given for the first 5 days, followed by the same PPI plus clarithromycin and either metrondiazole or tinidazole for a further 5 days, appears to eradicate infection more effectively than does standard triple therapy, based on systematic reviews of RCTs.   The two regimens have similar costs.   Sequential therapy is unsuitable for patients allergic to penicillin   The relative efficacy of sequential versus triple therapy may be related to ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5231188 Thu, 15 Sep 2011 04:00:00 +0100 5231188 http://www.medworm.com/index.php?rid=5231187&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FThe-role-of-antibacterials-in-women-at-risk-of-preterm-birth-%2F This article in the Drug and Therapeutics Bulletin (DTB) reviews the evidence and guidelines on antibacterial therapy in women at risk of preterm birth (delivery before 37 weeks' gestation). It found that "in women with asymptomatic bacteriuria, there is no clear-cut evidence of neonatal benefit from antibacterial therapy, but the maternal benefit in terms of a reduction in pyelonephritis means that pregnant women should be screened for bacteriuria (and treated), as recommended as a standard part of antenatal care. Otherwise, on balance, the current evidence suggests little benefit from the routine use of antibacterials for women either identified as being at risk of preterm labour antenatally, or who are in preterm labour, unless there is obvious infection present, or unless preterm prela... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5231187 Thu, 15 Sep 2011 04:00:00 +0100 5231187 http://www.medworm.com/index.php?rid=5189657&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDrug-therapy-for-treating-post-dural-puncture-headache%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture, an invasive procedure frequently performed in the emergency room. Numerous pharmaceutical drugs have been proposed to treat PDPH but there are still some uncertainties about their clinical effectiveness.   Objectives To assess the effectiveness and safety of drugs for treating PDPH in adults and children.   Search strategy The search strategy included the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2011, Issue 2), MEDLINE (from 1950 to June 2011), EMBASE (from 1980 to June 2011) and CINAHL (from 1982 to June 2011). T   Selection criteria We conside... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5189657 Tue, 30 Aug 2011 23:00:00 +0100 5189657 http://www.medworm.com/index.php?rid=5189656&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-prevention-and-treatment-of-vulvovaginal-candidiasis-in-women-with-HIV-infection%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Vulvovaginal candidiasis (VVC) is one of themost common fungal infections that recur frequently in HIV infected women. Symptoms of VVC are pruritis, discomfort, dyspareunia, and dysuria. Vulval infection presents as amorbiliform rash that may extend to the thighs.  Vaginal infection is associated with white discharge, and plaques are seen on erythematous vaginal walls.  Even though rarely or never resulting in systemic fungal infection or mortality, left untreated these lesions contribute considerably to the morbidity associated with HIV infection. Prevention and treatment of this condition is an essential part of maintaining the quality of life for these individuals.   Objectives -To comp... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5189656 Tue, 30 Aug 2011 23:00:00 +0100 5189656 http://www.medworm.com/index.php?rid=5189655&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTopical-and-systemic-antifungal-therapy-for-the-symptomatic-treatment-of-chronic-rhinosinusitis%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Chronic rhinosinusitis (CRS) is an inflammatory disorder of the nose and sinuses. Since fungi were postulated as a potential cause of CRS in the late 1990s, there has been increasing controversy about the use of both topical and systemic antifungal agents in its management. Although interaction between the immune system and fungus has been demonstrated in CRS, this does not necessarily imply that fungi are the cause of CRS or that antifungals will be effective its management.   Objectives To assess the effectiveness of topical or systemic antifungal therapy in the treatment of CRS.   Search strategy We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochra... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5189655 Tue, 30 Aug 2011 23:00:00 +0100 5189655 http://www.medworm.com/index.php?rid=5075013&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDressings-for-the-prevention-of-surgical-site-infection%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Surgical wounds (incisions) heal by primary intention when the wound edges are brought together and secured - often with sutures, staples, clips or glue. Wound dressings, usually applied after wound closure, provide physical support, protection from bacterial contamination and absorb exudate. Surgical site infection (SSI) is a common complication of surgical wounds that may delay healing.   Objectives To evaluate the effects of wound dressings for preventing SSI in people with surgical wounds healing by primary intention.   Search strategy We searched the Cochrane Wounds Group Specialised Register (searched 10 May 2011); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochran... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5075013 Wed, 27 Jul 2011 23:00:00 +0100 5075013 http://www.medworm.com/index.php?rid=5075012&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FIntratympanic-steroids-for-Menieres-disease-or-syndrome%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Ménière's disease is a disorder characterised by hearing loss, tinnitus and disabling vertigo. The use of intratympanic steroids to reduce the severity of these symptoms has been gaining popularity.   Objectives To assess the effectiveness of intratympanic steroids on the frequency and severity of attacks of vertigo, on chronic symptoms such as tinnitus, imbalance and hearing loss, and on the progression of these symptoms in patients with definite Ménière's disease or syndrome, as defined by the AAO-HNS Committee.   Search strategy We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CIN... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5075012 Wed, 27 Jul 2011 23:00:00 +0100 5075012 http://www.medworm.com/index.php?rid=5075011&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FLaryngeal-mask-airway-surfactant-administration-for-prevention-of-morbidity-and-mortality-in-preterm-infants-with-or-at-risk-of-respiratory-distress-syndrome%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Laryngeal mask airway (LMA) administration is one way of delivering surfactant to the infant lung, with the potential benefit of avoiding endotracheal intubation and ventilation, ventilator induced lung injury and bronchopulmonary dysplasia (BPD).   Objectives To determine the effect of LMA surfactant administration either as prophylaxis or treatment compared to placebo, no treatment, or intratracheal surfactant administration on morbidity and mortality in preterm infants with, or at risk of, respiratory distress syndrome (RDS).   Search strategy We searched CENTRAL (The Cochrane Library, October 2010), MEDLINE and PREMEDLINE (1950 to October 2010), EMBASE (1980 to October 2010) and CINAHL (19... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5075011 Wed, 27 Jul 2011 23:00:00 +0100 5075011 http://www.medworm.com/index.php?rid=5075010&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FLow-dose-rate-brachytherapy-for-men-with-localized-prostate-cancer%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Localized prostate cancer is a slow growing tumor for many years for the majority of affected men. Low-dose rate brachytherapy (LDR-BT) is short-distance radiotherapy using low-energy radioactive sources. LDR-BT has been recommended for men with low risk localized prostate cancer.   Objectives To assess the benefit and harm of LDR-BT compared to radical prostatectomy (RP), external beam radiotherapy (EBRT), and no primary therapy (NPT) in men with localized prostatic cancer.   Search strategy The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (from 1950), and EMBASE (from 1980) were searched in June 2010 as well as online trials registers and reference lists of reviews. &... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5075010 Wed, 27 Jul 2011 23:00:00 +0100 5075010 http://www.medworm.com/index.php?rid=5075009&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FReduced-dietary-salt-for-the-prevention-of-cardiovascular-disease%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background An earlier Cochrane review of dietary advice identified insufficient evidence to assess effects of reduced salt intake on mortality or cardiovascular events.   Objectives 1. To assess the long term effects of interventions aimed at reducing dietary salt on mortality and cardiovascular morbidity. 2. To investigate whether blood pressure reduction is an explanatory factor in any effect of such dietary interventions on mortality and cardiovascular outcomes.   Search strategy The Cochrane Library (CENTRAL, Health Technology Assessment (HTA) and Database of Abstracts of Reviews of Effect (DARE)), MEDLINE, EMBASE, CINAHL and PsycInfo were searched through to October 2008. References of included st... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5075009 Wed, 27 Jul 2011 23:00:00 +0100 5075009 http://www.medworm.com/index.php?rid=5025709&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDTB-Review-Systemic-lupus-erythematosus%2F Source: DTB Area: Evidence > Disease Focused Reviews The Drug and Therapeutics Bulletin has featured a review on the diagnosis and management of systemic lupus erythematosus (SLE). The following topics are discussed: . Pathology and clinical features of the condition . Diagnosis and referral . Traditional drug treatment options such as antimalarials and immunosuppressants . Newer drug treatment options such as rituximab and belimumab . Monitoring patients . SLE and pregnancy . SLE and antiphospholipid antibodies (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5025709 Tue, 12 Jul 2011 23:00:00 +0100 5025709 http://www.medworm.com/index.php?rid=5015885&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEfficacy-and-safety-of-pharmacological-interventions-for-the-treatment-of-the-Alcohol-Withdrawal-Syndrome%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Alcohol abuse and dependence represents a very serious health problem worldwide with major social, interpersonal and legal interpolations. Pharmacological treatments presently used are of uncertain effectiveness and there is even more doubt on the comparative effects and value for money.   Objectives To summarize Cochrane reviews that assess the effectiveness and safety of pharmacological interventions in the treatment of alcohol withdrawal.   Methods We searched the Cochrane Database of Systematic Reviews (30 November 2010). Two authors independently screened, extracted data, summarised key characteristics of the included reviews and assessed their quality using AMSTAR; the quality of the evi... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5015885 Sun, 10 Jul 2011 23:00:00 +0100 5015885 http://www.medworm.com/index.php?rid=5015884&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntipsychotic-medication-for-early-episode-schizophrenia%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Long-term treatment with antipsychotic medications in early episode schizophrenia spectrum disorders is common, but both short and long-term effects on the illness are unclear. There have been numerous suggestions that people with early episodes of schizophrenia appear to respond differently than those with multiple prior episodes. The number of episodes may moderate response to drug treatment.   Objectives To assess the effects of antipsychotic medication treatment on people with early episode schizophrenia spectrum disorders.   Search strategy We searched the Cochrane Schizophrenia Group register (July 2007) as well as references of included studies. We contacted authors of studies for furth... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5015884 Sun, 10 Jul 2011 23:00:00 +0100 5015884 http://www.medworm.com/index.php?rid=5015883&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FNitric-oxide-donors-for-cervical-ripening-and-induction-of-labour%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Sometimes it is necessary to bring on labour artificially because of safety concerns for the mother or baby. This review is one of a series of reviews of methods of labour induction using a standardised protocol.   Induction of labour occurs in approximately 20% of pregnancies in the UK. The ideal agent for induction of labour would induce cervical ripening without causing uterine contractions. Currently most commonly used cervical ripening or induction agents result in uterine activity or contractions, or both. Cervical ripening without uterine contractility could occur safely in an outpatient setting and it may be expected that this would result in greater maternal satisfaction and lower costs. &nbsp... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5015883 Sun, 10 Jul 2011 23:00:00 +0100 5015883 http://www.medworm.com/index.php?rid=5015882&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTargeting-intensive-glycaemic-control-versus-targeting-conventional-glycaemic-control-for-type-2-diabetes-mellitus%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Patients with type 2 diabetes mellitus (T2D) exhibit an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report a relationship between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patients with T2D.   Objectives To assess the effects of targeting intensive versus conventional glycaemic control in T2D patients.   Search strategy Trials were obtained from searches of CENTRAL (The Cochrane Library), MEDLINE, EMBASE, Science Citation Index Expanded, LILACS, and CINAHL (until December 2010). Selection criteria We included randomised clinical trials that prespecified different targets of... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5015882 Sun, 10 Jul 2011 23:00:00 +0100 5015882 http://www.medworm.com/index.php?rid=5004671&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDTB-Management-of-acute-infective-conjunctivitis%2F Source: DTB Area: Evidence > Disease Focused Reviews This review in the Drug and Therapeutics Bulletin (DTB) examines the evidence on the efficacy of antibacterials in acute infective conjunctivitis and provides practical information and advice for prescribers and community pharmacists on managing patients with the condition.   It contains the following conclusions and recommendations:   . Evidence from RCTs indicates that topical antibacterials offer a modest clinical benefit in infective conjunctivitis.   . As most cases are self-limiting, a 'wait and see' or delayed prescribing approach is likely to be most appropriate.   . The availability of topical chloramphenicol over the counter has increased its use and may have medicalised the i... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=5004671 Wed, 06 Jul 2011 23:00:00 +0100 5004671 http://www.medworm.com/index.php?rid=4890100&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDTB-review-Do-sunscreens-have-a-role-in-preventing-skin-cancer-%2F Source: DTB Area: Evidence > Disease Focused Reviews The Drug & Therapeutics Bulletin (DTB) has featured a review discussing whether the sunscreen products commonly used to prevent sunburn have a place in the prevention of skin cancer.   The review was conducted following the publication of the NICE public health guidance on the prevention of skin cancer, which recommended that a sunscreen with a sun protection factor (SPF) of at least 15 is enough.   The review discusses the following topics:   - the effects of UV radiation on the skin,   - what are sunscreens?   - do sunscreens prevent skin cancer?   - Choosing and using a sunscreen: states that an ideal sunscreen should provide good protection against UVA and U... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4890100 Tue, 31 May 2011 23:00:00 +0100 4890100 http://www.medworm.com/index.php?rid=4851590&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPhosphodiesterase-4-inhibitors-for-chronic-obstructive-pulmonary-disease%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Chronic obstructive pulmonary disease (COPD) affects symptoms, lung function, quality of life and life expectancy. Apart from smoking cessation, there are no other treatments that slow lung function decline. Roflumilast and cilomilast are oral phosphodiesterase 4 (PDE4) inhibitors proposed to reduce the airway inflammation and bronchoconstriction seen in COPD.   Objectives To evaluate the efficacy and safety of PDE4 inhibitors in the management of people with stable COPD. Outcomes included lung function, quality of life, symptoms, exacerbations and adverse effects.   Search strategy We identified randomised controlled trials (RCTs) from the Cochrane Airways Group Specialised Register of trials (... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4851590 Sat, 21 May 2011 23:00:00 +0100 4851590 http://www.medworm.com/index.php?rid=4851589&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FCorticosteroids-for-the-treatment-of-idiopathic-acute-vestibular-dysfunction-vestibular-neuritis%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Idiopathic acute vestibular dysfunction (vestibular neuritis) is the second most common cause of peripheral vertigo after benign paroxysmal positional vertigo (BPPV) and accounts for 7% of the patients who present at outpatient clinics specialising in the treatment of dizziness. The exact aetiology of the condition is unknown and the effects of corticosteroids on the condition and its recovery are uncertain.   Objectives To assess the effectiveness of corticosteroids in the management of patients with idiopathic acute vestibular dysfunction (vestibular neuritis).   Search strategy We searched the Cochrane ENT Group Trials Register; CENTRAL; PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Preview... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4851589 Sat, 21 May 2011 23:00:00 +0100 4851589 http://www.medworm.com/index.php?rid=4851588&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntiretroviral-therapy-for-prevention-of-HIV-transmission-in-HIV-discordant-couples%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Antiretroviral drugs have been shown to reduce risk of mother-to-child transmission of human immunodeficiency virus (HIV) and are also widely used for post-exposure prophylaxis for parenteral and sexual exposures. Observational data, ecological studies and models suggest that sexual transmission may be lower in couples in which one partner is infected with HIV and the other is not and the infected partner is on antiretroviral therapy (ART).   Objectives To determine if ART use in an HIV-infected member of an HIV-discordant couple is associated with lower risk of HIV transmission to the uninfected partner compared to untreated discordant couples.   Search strategy We used standard Cochrane meth... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4851588 Sat, 21 May 2011 23:00:00 +0100 4851588 http://www.medworm.com/index.php?rid=4851587&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntibiotic-prophylaxis-for-transrectal-prostate-biopsy%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Transrectal prostate biopsy (TRPB) is a well established procedure used to obtain tissue for the histological diagnosis of carcinoma of the prostate. Despite the fact that TRPB is generally considered a safe procedure, it may be accompanied by traumatic and infective complications, including asymptomatic bacteriuria (bacteria in the urine), urinary tract infection (UTI), transitory bacteremia (bacteria in the blood), fever episodes, and sepsis (pathogenic microorganisms or their toxins in the blood). Although infective complications after TRPB are well known, there is uncertainty about the necessity and effectiveness of routine prophylactic antibiotics and their adverse effects, as well as a clear lack of standar... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4851587 Sat, 21 May 2011 23:00:00 +0100 4851587 http://www.medworm.com/index.php?rid=4851591&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FProphylactic-corticosteroids-for-cardiopulmonary-bypass-in-adults%2F The objective of this meta-analysis was to estimate the effect of prophylactic corticosteroids in cardiac surgery on mortality, cardiac and pulmonary complications.   Search strategy Major medical databases (CENTRAL, MEDLINE, EMBASE, CINAHL and Web of Science) were systematically searched for randomised studies assessing the effect of corticosteroids in adult cardiac surgery. Database were searched for the full period covered, up to December 2009. No language restrictions were applied.   Selection criteria Randomised controlled trials comparing corticosteroid treatment to either placebo treatment or no treatment in adult cardiac surgery ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4851591 Fri, 20 May 2011 23:00:00 +0100 4851591 http://www.medworm.com/index.php?rid=4846487&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAnalgesia-for-relief-of-pain-due-to-uterine-crampinginvolution-after-birth%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Women may experience differing types of pain and discomfort following birth, including cramping after birth pains associated with uterine involution.   Objectives To assess the effectiveness and safety of analgesia for relief of after birth pains following vaginal birth.   Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2010) and the reference lists of trials and review articles.   Selection criteria All identified published and unpublished randomised controlled trials comparing two different types of analgesia or analgesia with placebo or analgesia with no treatment, for the relief of after birth pains following vaginal birth.... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4846487 Thu, 19 May 2011 23:00:00 +0100 4846487 http://www.medworm.com/index.php?rid=4846486&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAnti-vascular-endothelial-growth-factor-for-prevention-of-postoperative-vitreous-cavity-haemorrhage-after-vitrectomy-for-proliferative-diabetic-retinopathy%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Postoperative vitreous cavity haemorrhage (POVCH) is a significant complication following vitrectomy for proliferative diabetic retinopathy (PDR). It delays visual recovery and can make further treatment difficult if the view of the fundus is significantly obscured. A number of interventions to reduce the incidence of POVCH have been proposed, including the perioperative use of anti-vascular endothelial growth factor (anti-VEGF). Anti-VEGFs reduce vascular proliferation and the vascularity of neovascular tissue, which is often the source of bleeding following vitrectomy.   Objectives The review aims to assess the effect of perioperative anti-VEGF in reducing the incidence of POVCH.   Sear... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4846486 Thu, 19 May 2011 23:00:00 +0100 4846486 http://www.medworm.com/index.php?rid=4846485&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTreatment-of-valvular-heart-disease-during-pregnancy-for-improving-maternal-and-neonatal-outcome%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Valvular heart disease constitutes the majority of all causes of heart disease in pregnancy. In the presence of valvular heart disease, the necessary haemodynamic changes of pregnancy might cause heart failure, leading to severe maternal and fetal morbidity and even mortality. Treatment of valvular heart disease is indicated when patients experience a deterioration of symptoms and in case of a severe valvular lesion. Whether medical therapy or interventional therapy is the optimal treatment for both mother and child is unclear.   Objectives To assess effectiveness and adverse effects of the different treatment modalities of valvular heart disease in pregnancy to improve maternal and neonatal outcome... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4846485 Thu, 19 May 2011 23:00:00 +0100 4846485 http://www.medworm.com/index.php?rid=4846484&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTreatment-for-sialorrhea-excessive-saliva-in-people-with-motor-neuron-diseaseamyotrophic-lateral-sclerosis%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Motor neuron disease (MND), also known as amyotrophic lateral sclerosis, is a progressive, neurodegenerative condition which may cause dysphagia, as well as limb weakness, dysarthria, emotional lability and respiratory failure. Since normal salivary production is 0.5 to 1.5 litres daily, loss of salivary clearance due to dysphagia leads to salivary pooling and sialorrhea, often resulting in distress and inconvenience to patients.   Objectives To systematically review evidence on treatment of sialorrhea in MND, including medications, radiotherapy and surgery.   Search strategy We searched the Cochrane Neuromuscular Disease Group Specialized Register (1 October 2010), the Cochrane Central ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4846484 Thu, 19 May 2011 23:00:00 +0100 4846484 http://www.medworm.com/index.php?rid=4846483&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTopical-nasal-steroids-for-treating-nasal-polyposis-in-people-with-cystic-fibrosis%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Nasal polyps frequently occur in people with cystic fibrosis. Sinus infections have been shown to be a factor in the development of serious chest complications in these people. Nasal polyps have been linked to a higher risk of lower respiratory tract infections with Pseudomonas aeruginosa . Topical nasal steroids are of proven efficacy for treating nasal polyposis in the non-cystic fibrosis population. There is no clear current evidence for the efficacy of topical steroids for nasal polyps in people with cystic fibrosis.   Objectives To assess the effectiveness of topical nasal steroids for treating symptomatic nasal polyps in people with cystic fibrosis.   Search strategy We searched the Coch... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4846483 Thu, 19 May 2011 23:00:00 +0100 4846483 http://www.medworm.com/index.php?rid=4787021&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FMedical-interventions-for-high-grade-vulval-intraepithelial-neoplasia%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Vulval intraepithelial neoplasia (VIN) is a pre-malignant condition of the vulval skin; its incidence is increasing in women under 50 years. VIN is graded histologically as low grade or high grade. High grade VIN is associated with infection with human papilloma virus (HPV) infection and may progress to invasive disease. There is no consensus on the optimal management of high grade VIN. The high morbidity and high relapse rate associated with surgical interventions call for a formal appraisal of the evidence available for less invasive but effective interventions for high grade VIN.   Objectives To evaluate the effectiveness and safety of medical interventions for high grade V... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4787021 Wed, 04 May 2011 23:00:00 +0100 4787021 http://www.medworm.com/index.php?rid=4787020&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPharmacological-treatment-for-Attention-Deficit-Hyperactivity-Disorder-ADHD-in-children-with-comorbid-tic-disorders%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent of the comorbid psychiatric disorders that complicate tic disorders. Medications commonly used to treat ADHD symptoms include the stimulants methylphenidate and amphetamine; nonstimulants, such as atomoxetine; tricyclic antidepressants; and alpha agonists. Due to the impact of ADHD symptoms on the child with tic disorder, treatment of ADHD is often of greater priority than the medical management of tics. However, for many decades clinicians have been reluctant to use stimulants to treat children with ADHD and tics for fear of worsening their tics.   Objectives To assess the effects of pharmacological treatme... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4787020 Wed, 04 May 2011 23:00:00 +0100 4787020 http://www.medworm.com/index.php?rid=4787019&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTreatment-of-obstructive-sleep-apnoea-for-chronic-cough-in-children%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Childhood obstructive sleep apnoea (OSA) is a disorder that is characterised by repeated episodes of partial or complete upper airway obstruction (UAO) during sleep that result in disruption of normal ventilation and sleep patterns. Chronic cough in children is a significant medical problem and in some situations warrants thorough investigation. There may be an association between chronic cough and OSA as suggested in adult studies.   Objectives To evaluate the efficacy of treatment of OSA leading to the resolution of cough in the management of children with chronic cough.   Search strategy We searched the Cochrane Register of Controlled Trials (CENTRAL, The Cochr... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4787019 Wed, 04 May 2011 23:00:00 +0100 4787019 http://www.medworm.com/index.php?rid=4787022&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDTB-review-on-the-management-of-diffuse-oesophageal-spasm%2F This article discusses the diagnosis and management of patients with diffuse oesophageal spasm (DOS), an oesophageal motility disorder that accounts for around 10% of all presentations for non-cardiac chest pain.   The following topics are discussed:   . What is DOS? . Diagnosing DOS (initial investigations, manometry) . Treating oesophageal spasm (lifestyle interventions, antispasmodics and smooth muscle relaxants, botulinum toxin, antidepressants and psychological therapy, balloon dilatation, surgery) . Cost issues   In the conclusion, the authors note that there are limited therapeutic options for DOS (none are licensed) and management is uncertain due to limited evidence.    Initial therapy for DOS will usually consist... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4787022 Tue, 03 May 2011 23:00:00 +0100 4787022 http://www.medworm.com/index.php?rid=4718391&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntenatal-interventions-for-preventing-the-transmission-of-cytomegalovirus-CMV-from-the-mother-to-fetus-during-pregnancy%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Title: Antenatal interventions for preventing the transmission of cytomegalovirus (CMV) from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant   Background Cytomegalovirus (CMV) is a herpesvirus and the most common cause of congenital infection in developed countries. Congenital CMV infection can have devastating consequences to the fetus. The high incidence and the serious morbidity associated with congenital CMV infection emphasise the need for effective interventions to prevent the antenatal transmission of CMV infection.   Objectives The aim of this review was to assess the benefits and harms of interventions used during pregnancy... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4718391 Thu, 14 Apr 2011 23:00:00 +0100 4718391 http://www.medworm.com/index.php?rid=4708191&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDopamine-agonists-for-restless-legs-syndrome%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background According to clinical guidelines, dopamine agonists are the first-line treatment of restless legs syndrome (RLS).   Objectives To evaluate efficacy and safety of dopamine agonists for RLS.   Search strategy We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 4), MEDLINE, EMBASE, PsycINFO and CINAHL, from January 1985 to December 2008, plus reference lists of articles. We contacted pharmaceutical companies.   Selection criteria We included double-blind randomised controlled trials (RCTs) of dopamine agonist treatment versus placebo or other treatment for a period of at least seven days in patients with RLS (? 18 ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4708191 Tue, 12 Apr 2011 23:00:00 +0100 4708191 http://www.medworm.com/index.php?rid=4708190&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FCorticosteroids-for-pneumonia%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Pneumonia is an acute inflammation of the lungs and treatments differ depending on the type and severity. Corticosteroids can influence immune regulation, carbohydrate metabolism, protein catabolism, electrolyte balance and stress response. However, the benefits of corticosteroids for patients with pneumonia remains unclear.   Objectives To assess the efficacy and safety of corticosteroids in the treatment of pneumonia.   Search strategy We searched Cochrane Central Register of Controlled Clinical Trials (CENTRAL) (The Cochrane Library 2010, Issue 11) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to December ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4708190 Tue, 12 Apr 2011 23:00:00 +0100 4708190 http://www.medworm.com/index.php?rid=4708189&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntioxidant-supplements-for-liver-diseases%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Several liver diseases have been associated with oxidative stress. Accordingly, antioxidants have been suggested as potential therapeutics for various liver diseases. The evidence supporting these suggestions is equivocal.   Objectives To assess the benefits and harms of antioxidant supplements for patients with liver diseases.     Search strategy We searched The Cochrane Library, MEDLINE, EMBASE, LILACS, the Science Citation Index Expanded, and Conference Proceedings Citation Index-Science to January 2011. We scanned bibliographies of relevant publications and asked experts and pharmaceutical companies for additional trials.   Selection criteri... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4708189 Tue, 12 Apr 2011 23:00:00 +0100 4708189 http://www.medworm.com/index.php?rid=4702444&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-improving-palliative-care-for-older-people-living-in-nursing-care-homes%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Residents of nursing care homes for older people are highly likely to die there, making these places where palliative care is needed.   Objectives The primary objective was to determine effectiveness of multi-component palliative care service delivery interventions for residents of care homes for older people. The secondary objective was to describe the range and quality of outcome measures.   Search strategy The grey literature and the following electronic databases were searched: Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness (all issue 1, 2010); MEDLINE, EMBASE, CINAHL, Brit... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4702444 Sun, 10 Apr 2011 23:00:00 +0100 4702444 http://www.medworm.com/index.php?rid=4702443&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FHaematological-interventions-for-treating-disseminated-intravascular-coagulation-during-pregnancy-and-postpartum%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Disseminated intravascular coagulation (DIC) is an acquired syndrome characterised by systemic intravascular activation of coagulation. There are several obstetric causes of DIC during pregnancy and postpartum.   Objectives To assess the clinical effectiveness and safety of haematological interventions such as heparins (low molecular weight heparin (LMWH) and unfractionated heparin (UFH), danaparoid sodium, synthetic protease inhibitor, antithrombin, human recombinant activated protein C, recombinant human soluble thrombomodulin, recombinant tissue factor pathway inhibitor, recombinant activated factor VIIa and any other types of haematological interventions (except transfusi... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4702443 Sun, 10 Apr 2011 23:00:00 +0100 4702443 http://www.medworm.com/index.php?rid=4681620&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDTB-reviews-chemotherapy-for-inoperable-liver-metastases-from-colorectal-cancer-%2F Source: Drug and Therapeutics Bulletin (DTB) Area: Evidence > Disease Focused Reviews This review from the Drug and Therapeutics Bulletin (DTB) looks at recent advances in chemotherapy for patients with colorectal cancer who have unresectable liver metastases, which aims to render these lesions operable, to potentially improve their survival.   The following topics are discussed:   . Key growth factors in colorectal cancer . Referral and investigation . Surgery for liver metastases . Surgery plus standard chemotherapy . The role of 'targeted' therapies (cetuximab; panitumumab; bevacizumab; bevacizumab plus panitumumab or cetuximab)   In their conclusion, the authors comment that it is now possible to convert initially unresectabl... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4681620 Tue, 05 Apr 2011 23:00:00 +0100 4681620 http://www.medworm.com/index.php?rid=4681623&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FProton-pump-inhibitors-for-the-prevention-of-stress-related-mucosal-disease-in-critically-ill-patients-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The review found a significantly lower rate of clinically important bleeding when using proton pump inhibitors rather than histamine-2 receptor antagonists in the prevention of stress-related mucosal disease in critically ill patients. Rates of nosocomial pneumonia were similar. The reliability of the authors' conclusions is unclear due to some methodological weaknesses and differences between the small number of studies. [Included studies were of omeprazole compared with ranitidine, famotidine or cimetidine.] CRD Commentary: The review addressed a well-defined question in terms of participants, interventions, study design and relevant outcomes. Relevant databases were searched, but it appeared that unpublished studies... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4681623 Mon, 04 Apr 2011 23:00:00 +0100 4681623 http://www.medworm.com/index.php?rid=4681622&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FATG-plus-cyclosporine-reduces-all-cause-mortality-in-patients-with-severe-aplastic-anemia-systematic-review-and-meta-analysis%2F The objectives and inclusion criteria of the review were clear and relevant sources were searched for studies. A specific attempt was made to retrieve unpublished studies, but no test for publication bias appeared to be conducted. It was unclear whether the search was restricted by language. Steps were taken to minimise the risk of reviewer bias and error by having more than one reviewer involved in selection of studies, assessment of validity and data extraction. Some relevant criteria were used to assess study validity, but no ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4681622 Mon, 04 Apr 2011 23:00:00 +0100 4681622 http://www.medworm.com/index.php?rid=4681621&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FChemotherapy-for-recurrent-metastatic-or-persistent-cervical-cancer-a-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that cisplatin plus topotecan should be offered as a treatment option to appropriate patients with recurrent, metastatic or persistent cervical cancer; further research was required. There were several considerations with the included studies, but the authors' conclusions appeared to reflect the evidence available and their recommendations for further research seem appropriate. CRD Commentary: The review question and inclusion criteria were clear, and were supported by a comprehensive search of the literature for published and unpublished publications. Only articles published in English were searched, hence language bias may have been introduced. The authors reported that the quality of included st... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4681621 Mon, 04 Apr 2011 23:00:00 +0100 4681621 http://www.medworm.com/index.php?rid=4675202&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPharmacological-treatment-other-than-corticosteroids-intravenous-immunoglobulin-and-plasma-exchange-for-Guillain-Barre-syndrome%2F Discussion.   Selection criteria We included all randomised or quasi-randomised controlled trials of acute (within four weeks from onset) GBS of all types, ages and degrees of severity. We discarded trials ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4675202 Sun, 03 Apr 2011 23:00:00 +0100 4675202 http://www.medworm.com/index.php?rid=4675201&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FVaccination-for-preventing-postherpetic-neuralgia%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Herpes zoster virus vaccine was recommended for the prevention of herpes zoster and its sequelae by the Advisory Committee on Immunization Practices (ACIP) in 2006. To date the efficacy and safety of vaccination for preventing the most common complication of zoster, postherpetic neuralgia, has not been systematically reviewed.   Objectives To assess the efficacy and safety of vaccination in preventing postherpetic neuralgia.   Search strategy We searched MEDLINE (January 1966 to December 2010), EMBASE (January 1980 to January 2011), LILACS (January 1982 to December 2010), the Cochrane Neuromuscular Disease (NMD) Group Specialized Register (10 January 2010), the Cochrane ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4675201 Sun, 03 Apr 2011 23:00:00 +0100 4675201 http://www.medworm.com/index.php?rid=4675200&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FVaccines-for-prophylaxis-of-viral-infections-in-patients-with-hematological-malignancies%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Viral infections cause significant morbidity and mortality in patients with hematological malignancies. It remains uncertain whether viral vaccinations in these patients are supported by good evidence.   Objectives We aimed to determine the effectiveness and safety of viral vaccines in patients with hematological malignancies.   Search strategy We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL (June 2010), reference lists of relevant papers, abstracts from scientific meetings and contacted vaccine manufacturers. Selection criteria Randomized controlled trials (RCTs) evaluating viral vaccines in patients with hematological mal... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4675200 Sun, 03 Apr 2011 23:00:00 +0100 4675200 http://www.medworm.com/index.php?rid=4675199&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEvidence-based-treatment-of-herpes-simplex-virus-keratitis-a-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that trifluridine, acyclovir and possibly interferon were effective for herpes simplex virus epithelial keratitis. Corticosteroids with an antiviral were effective for Herpes simplex virus stromal keratitis and long-term acyclovir reduced recurrence. The validity of these conclusions may be limited by the small size of studies, restriction to articles published in English and the method of data extraction. CRD Commentary: The inclusion criteria appeared adequate. However, the search of only one database may have missed relevant studies and the restriction to studies published in English could have introduced language bias. Appropriate methods were used to minimise errors and bias in study selection,... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4675199 Sun, 03 Apr 2011 23:00:00 +0100 4675199 http://www.medworm.com/index.php?rid=4675198&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FA-meta-analysis-of-randomized-controlled-trials-comparing-chemotherapy-plus-bevacizumab-with-chemotherapy-alone-in-metastatic-colorectal-cancer%2F The objectives and inclusion criteria of the review were clear and relevant sources were searched for studies. The apparent restriction to published papers meant that some studies may have been missed, but testing for publication bias showed no evidence of this. It was not stated whether the search was limited by language. Steps were taken to minimise the risk of reviewer bias and error by having more than one ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4675198 Sun, 03 Apr 2011 23:00:00 +0100 4675198 http://www.medworm.com/index.php?rid=4657303&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntidepressants-for-agitation-and-psychosis-in-dementia%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Agitation and psychosis are common among older adults with dementia and are challenging to manage. At the present time, little is known about the efficacy and safety of antidepressant medications when used to treat these symptoms.   Objectives To assess the safety and efficacy of antidepressants in treating psychosis and agitation in older adults with Alzheimer's disease, vascular, or mixed dementia.   Search strategy We searched the Cochrane Dementia and Cognitive Improvement Group's Specialized Register which included Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), MEDLINE (January 1950 to October 2009), EMBASE (1980 - October 2009),... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4657303 Tue, 29 Mar 2011 23:00:00 +0100 4657303 http://www.medworm.com/index.php?rid=4657302&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAcetylcholinesterase-inhibitor-treatment-for-myasthenia-gravis%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background In myasthenia gravis, antibody-mediated blockade of acetylcholine receptors at the neuromuscular junction abolishes the naturally occurring 'safety factor' of synaptic transmission. Acetylcholinesterase inhibitors provide temporary symptomatic treatment of muscle weakness, but there is controversy about their long-term efficacy, dosage and side effects.   Objectives To evaluate the efficacy of acetylcholinesterase inhibitors in all forms of myasthenia gravis.   Search strategy We searched The Cochrane Neuromuscular Disease Group Specialized Register (5 October 2009), The Cochrane Central Register of Controlled Trials CENTRAL) (The Cochrane Library Issue 3, 2009), MEDLINE... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4657302 Tue, 29 Mar 2011 23:00:00 +0100 4657302 http://www.medworm.com/index.php?rid=4657301&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FChemotherapy-alone-versus-chemotherapy-plus-radiotherapy-for-early-stage-Hodgkin-lymphoma%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Combined modality treatment (CMT) consisting of chemotherapy followed by localised radiotherapy is standard treatment for patients with early stage Hodgkin lymphoma (HL). However, due to long term adverse effects such as secondary malignancies, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication.   Objectives We performed a systematic review with meta-analysis of randomised controlled trials (RCTs) comparing chemotherapy alone with CMT in patients with early stage Hodgkin lymphoma with respect to response rate, progression-free survival (alternatively tumour control) and overall survival (OS). &nbsp... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4657301 Tue, 29 Mar 2011 23:00:00 +0100 4657301 http://www.medworm.com/index.php?rid=4657300&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FFactor-Xa-inhibitors-for-acute-coronary-syndromes%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background The activation of coagulation mechanisms plays a central role in the pathogenesis of acute coronary syndromes (ACS). Administration of unfractionated heparin (UFH) and low molecular weight heparins (LMWH), agents preventing the progression of thrombus formation, is a crucial therapeutic strategy. However, some limitations related to their use have recently stimulated the development of new synthetic agents.   Objectives To evaluate the clinical efficacy and safety of factor Xa inhibitors for treatment of ACS compared to UFH or LMWH.   Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) of the Cochrane Library (Issue 1, 2008), PubMed, E... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4657300 Tue, 29 Mar 2011 23:00:00 +0100 4657300 http://www.medworm.com/index.php?rid=4657299&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTocolysis-for-management-of-retained-placenta%2F Source: Cochrane Database of Systematic Reviews Area: Evidence > Disease Focused Reviews Background Retained placenta affects 0.5% to 3% of women following delivery, with considerable morbidity if left untreated. Use of tocolytics, either alone or in combination with uterotonics, may be of value to minimise the need for manual removal of the placenta in theatre under anaesthesia.   Objectives Evaluate the benefits and harms of tocolytics alone or in addition to uterotonics in the management of retained placenta in order to reduce the need for manual removal of placenta.   Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2010) and contacted experts in the field.   Selection criteria Any adequately randomised ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4657299 Tue, 29 Mar 2011 23:00:00 +0100 4657299 http://www.medworm.com/index.php?rid=4640275&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEfficacy-and-tolerability-of-Hypericum-perforatum-in-major-depressive-disorder-in-comparison-with-selective-serotonin-reuptake-inhibitors-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review assessed the efficacy and tolerability of Hypericum perforatum against selective serotonin reuptake inhibitors for the treatment of major depressive disorder and concluding that there was no difference in outcomes, except for lower withdrawal rates for Hypericum due to adverse events. The authors' conclusions accurately reflected the evidence presented and are likely to be reliable. [The most frequent comparison of Hypericum perforatum (St John's wort) was with fluoxetine.] CRD Commentary: The review question and inclusion criteria were clear. The search strategy consulted a number of relevant sources; no language or publication restrictions were placed upon the search, which reduced the potential for ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4640275 Sun, 27 Mar 2011 23:00:00 +0100 4640275 http://www.medworm.com/index.php?rid=4640274&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInsulin-therapy-in-type-2-diabetes-what-is-the-evidence%2F The objectives and inclusion criteria of the review were clear and relevant sources were searched for studies. Only two databases were used, the search was limited by language and it did not appear that specific attempts were made to retrieve unpublished studies, so it was possible that some studies were missed. It did not appear that steps were taken to minimise the risk of reviewer error and bias by having more than one reviewer independently make decisions about review processes; potentially eligible studies were selected by a single reviewer and the processes used for final study ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4640274 Sun, 27 Mar 2011 23:00:00 +0100 4640274 http://www.medworm.com/index.php?rid=4640273&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FThe-effect-of-dyslipidemic-drugs-on-mortality-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review evaluated the effect of lipid-lowering drugs on coronary artery disease and cardiovascular disease mortalities, and all-cause mortality. The authors concluded that reductions of 15 to 25% in the relative odds of developing these outcomes can be achieved. This was largely a well-conducted review, but the absence of trial quality assessment represents a threat to the reliability of findings. [The included drugs were cholestyramine, clofibrate, fluvastatin, gemfibrozil, lovastatin, pravastatin and simvastatin.] CRD Commentary: This review addressed a clear research question. This was supported by inclusion criteria, which were detailed for study design and outcomes, and broad for the intervention of interest. ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4640273 Sun, 27 Mar 2011 23:00:00 +0100 4640273 http://www.medworm.com/index.php?rid=4620527&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPharmacological-management-of-primary-open-angle-glaucoma-second-line-options-and-beyond%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that a combination of drugs from different first-choice classes in the treatment of primary open-angle glaucoma was associated with an additional intra-ocular pressure (IOP) decrease, but the exact magnitude of this effect remained unclear. Without further details on study quality and given the other methodological concerns it is difficult to judge the reliability of the authors' conclusions. [Most treatment arms used combinations of a ?-blocker with a carbonic anhydrase inhibitor, an ?2-adrenoceptor agonist or a hypotensive lipid.] CRD Commentary: This review's inclusion criteria were clear. Several relevant databases were searched. Efforts were made to find published studies with language restri... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4620527 Tue, 22 Mar 2011 00:00:00 +0100 4620527 http://www.medworm.com/index.php?rid=4614228&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FFall-prevention-with-supplemental-and-active-forms-of-vitamin-D-a-meta-analysis-of-randomised-controlled-trials%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that supplemental vitamin D at doses between 700 and 1000 IU per day reduced the risk of falling among older individuals by 19%. This primary conclusion is probably reliable despite the poor reporting of some aspects of the review. However, concerns with the appropriateness of the synthesis make other conclusions less reliable. CRD Commentary: The review question and inclusion criteria were clear. The authors searched relevant databases and other sources and made some attempts to identify unpublished studies. The authors reported using methods designed to reduce reviewer bias and error in the extraction of data, but not in the selection of studies and in the assessment of validity. The validity asse... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4614228 Mon, 21 Mar 2011 00:00:00 +0100 4614228 http://www.medworm.com/index.php?rid=4614227&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FStatins-for-the-prevention-and-treatment-of-infections-a-systematic-review-and-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that statin use may be associated with benefits in treating and preventing infections, but given the heterogeneity between studies and evidence of publication bias, randomised controlled trials are needed to confirm this benefit of statin use. These conclusions are likely to be reliable. [Statins used were atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin and simvastatin.] CRD Commentary: The review question and the inclusion criteria were clear. The authors searched several relevant databases, including one which listed conference abstracts. This, together with the lack of language restrictions, reduced the chances of relevant studies being omitted or biases being introduced. Howev... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4614227 Mon, 21 Mar 2011 00:00:00 +0100 4614227 http://www.medworm.com/index.php?rid=4589053&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPrimary-prevention-of-cardiovascular-mortality-and-events-with-statin-treatments-a-network-meta-analysis-involving-more-than-65000-patients%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that statin treatment used for the primary prevention of cardiovascular disease was effective in reducing cardiovascular death and other major cardiovascular events. The conduct and reporting of the review were good and the conclusions are likely to be reliable. [Included studies assessed atorvastatin, fluvastatin, pravastatin and lovastatin.] CRD Commentary: The inclusion criteria for this review were clearly stated. The search was extensive and no language restrictions were applied, thus the possibility of missed studies and the introduction of publication and language biases was reduced. The authors stated that tests showed no evidence of publication bias. The methods used for study selection a... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4589053 Tue, 15 Mar 2011 00:00:00 +0100 4589053 http://www.medworm.com/index.php?rid=4589052&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FRole-of-prophylactic-antibiotics-in-laparoscopic-cholecystectomy-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This generally well-conducted review concluded that use of prophylactic antibiotics was not associated with a significant benefit for the prevention of infections in low-risk patients (those without cholelithiasis or cholangitis) who underwent laparoscopic cholecystectomy. This conclusion is likely to be reliable. [Included RCTs evaluated the antibiotics cefazolin, cefotetan, cefotaxime and cefuroxime.] CRD Commentary: The review question and inclusion criteria were clear. Several relevant databases were searched. Efforts were made to find published and unpublished studies to minimise the potential for publication bias. Publication bias was further evaluated and little evidence of it found. No language restrictions wer... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4589052 Tue, 15 Mar 2011 00:00:00 +0100 4589052 http://www.medworm.com/index.php?rid=4589055&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FHow-much-does-pharmacologic-prophylaxis-reduce-postoperative-vomiting-in-children-Calculation-of-prophylaxis-effectiveness-and-expected-incidence%2F The objectives and inclusion criteria of the review were clear, but the reason for the exclusion of a number of studies was not explained clearly. The search was limited to one database and it did not appear that efforts were made to locate unpublished studies, so studies may have been missed and the review may have been prone to publication bias. It was unclear whether the ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4589055 Mon, 14 Mar 2011 00:00:00 +0100 4589055 http://www.medworm.com/index.php?rid=4589054&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FMeta-analysis-comparison-nine-trials-of-outcomes-with-drug-eluting-stents-versus-bare-metal-stents-in-patients-with-diabetes-mellitus%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review compared outcomes of drug-eluting stent and bare-metal stent implantation in diabetic patients. The authors concluded that drug-eluting stents resulted in lower risk of in-stent restenosis and target lesion revascularisation and decreased incidence of myocardial infection during follow up with no impact on mortality or stent thrombosis. In general, the conclusions are likely to be reliable. [Included studies reported on sub-populations of diabetic patients using Sirolimus (six studies) or Paclitaxel (three studies) drug-eluting stents.] CRD Commentary: This review had clearly stated inclusion and exclusion criteria in terms of participants, study design, interventions and outcomes. The authors searched rele... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4589054 Mon, 14 Mar 2011 00:00:00 +0100 4589054 http://www.medworm.com/index.php?rid=4558258&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEfficacy-and-safety-of-drug-eluting-stents-in-ST-segment-elevation-myocardial-infarction-a-meta-analysis-of-randomized-trials%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review compared the use of drug-eluting stents to bare-metal stents in patients with ST-segment elevation myocardial infarction. Drug-eluting stent use was found to significantly decrease target-vessel revascularisation at one to two years of follow- up. Insufficient information was presented about the quality of the studies, which makes it difficult to draw conclusions about the reliability of the authors' conclusions. CRD Commentary: The review addressed a clear question and the criteria for the inclusion of studies in the review were clearly stipulated. The search was adequate and was designed to minimise language and publication biases. The authors reported using methods designed to reduce reviewer bi... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4558258 Mon, 07 Mar 2011 00:00:00 +0100 4558258 http://www.medworm.com/index.php?rid=4539568&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDTB-review-Post-exposure-prophylaxis-for-HIV%2F Source: Drug and Therapeutics Bulletin Area: Evidence > Disease Focused Reviews The Drug and Therapeutics Bulletin (DTB) has featured a review discussing the evidence to support post-exposure prophylaxis (PEP) with antiretroviral drugs following occupational and non-occupational exposure to human immunodeficiency virus (HIV) infection. The review also discusses available guidelines for use in both cases, and states that with respect to occupational exposure, despite the limited evidence base, PEP for HIV is well-established. With respect to non-occupational exposure, PEP should also be used in combination with other HIV prevention strategies.   The review concludes that "It is also important that clinicians (e.g. working in accident and emergency, out-of-hours services and primar... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4539568 Wed, 02 Mar 2011 00:00:00 +0100 4539568 http://www.medworm.com/index.php?rid=4493700&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FOral-anticoagulant-therapy-in-patients-with-mechanical-heart-valve-and-intracranial-haemorrhage-a-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The optimal management of oral anticoagulant therapy after intracranial bleeding secondary to vitamin K antagonist use in patients with a mechanical heart valve was investigated. The authors concluded that restarting or stopping anticoagulant therapy for a few days appeared to be safe, but the quality of evidence was low. The review was generally well conducted and the authors' conclusions appear appropriate. [The antithrombotic therapies used were warfarin, enoxaparin, nadroparin, heparin and dipyridamole where reported.] CRD Commentary: The research question was supported by inclusion criteria for participants, study design and intervention. Only published studies in four languages were sought, so the possibility of ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4493700 Fri, 18 Feb 2011 00:00:00 +0100 4493700 http://www.medworm.com/index.php?rid=4493699&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FMeta-analysis-of-prophylactic-allopurinol-use-in-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review reported that allopurinol treatment showed no significant benefit for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis. This review was generally well-conducted and the authors' conclusion is likely to be reliable. CRD Commentary: This review's inclusion criteria were clear. Several relevant databases were searched. Efforts were made to find published but not unpublished studies, thereby introducing the potential for publication bias. Publication bias was investigated but little evidence was found. The authors did not state whether language restrictions were applied in the search, which made it difficult to assess the risk of language bias. Steps were taken to minimise bias ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4493699 Fri, 18 Feb 2011 00:00:00 +0100 4493699 http://www.medworm.com/index.php?rid=4493697&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FMultiple-treatments-meta-analysis-of-chemotherapy-and-targeted-therapies-in-advanced-breast-cancer%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that there were many options for first and subsequent lines of therapy, including chemotherapy and targeted therapies, that have comparable efficacy in advanced breast cancer. Overall, the authors' conclusions appear valid, but the lack of any assessment of trial quality and the use of both direct and indirect evidence, suggests that the findings should be interpreted cautiously. [Trials included in the review compared various drug regimens from the following groups of therapies: anthracyclines, anthracenediones, non-taxane novel chemotherapies (capecitabine, gemcitabine or vinorelbine), taxanes, thalidomide, marimastat, trastuzumab, lapatinib, bevacizumab and older miscellaneous treatments.] CRD ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4493697 Fri, 18 Feb 2011 00:00:00 +0100 4493697 http://www.medworm.com/index.php?rid=4487966&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FThe-benefits-of-steroids-versus-steroids-plus-antivirals-for-treatment-of-Bells-palsy-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review evaluated whether steroid treatment plus antivirals provided a greater degree of facial muscle recovery than steroids alone in patients with Bell's palsy. The authors concluded that combined treatment provided no additional benefit in achieving at least partial facial muscle recovery. This was a generally well-conducted review, and the authors' conclusion is likely to be reliable. [The included steroid was oral prednisone or prednisolone; the included antivirals were acyclovir, valacyclovir, and famcyclovir.] CRD Commentary: This review addressed a clear question, and this was supported by potentially reproducible inclusion criteria. The search strategy included various relevant sources, and attempts were m... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4487966 Wed, 16 Feb 2011 00:00:00 +0100 4487966 http://www.medworm.com/index.php?rid=4487965&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FProphylactic-antibiotics-in-necrotizing-pancreatitis-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors concluded that prophylactic antibiotics did not reduce mortality, rate of infected necrosis or the need for surgical intervention in patients with necrotising pancreatitis, but that they did reduce the risk of non-pancreatic infections and length of hospital stay. Given the unclear quality of the included trials, the reliability of the authors' conclusions is unclear. [Prophylactic antibiotics used in the included trials were meropenem, cefuroxime, imipenem, ciprofloxacin plus metronidazole, and imipenem plus cilastatin or ofloxacin plus metronidazole.] CRD Commentary: The review addressed a clear question. Inclusion criteria for intervention, study design, outcomes and participants were well-defined. Sever... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4487965 Wed, 16 Feb 2011 00:00:00 +0100 4487965 http://www.medworm.com/index.php?rid=4487964&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FGlucagon-like-peptide-1-receptor-agonists-in-type-2-diabetes-a-meta-analysis-of-randomized-clinical-trials%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The review concluded that the prophylactic use of glucagon-like peptide-1 receptor agonists for type 2 diabetes effectively reduced glycosylated haemoglobin and postprandial glucose; it had a similar effect to insulin in patients unresponsive to sulphonylurea or metformin. The safety profile was reassuring. The review had no major flaws, but the presence of heterogeneity makes the reliability of the conclusions unclear. [The included trials were of liraglutide and exenatide. The comparator groups in the included trials were placebo, insulin or active comparators (metformin, glimepiride and glargine).] CRD Commentary: The review addressed a well-defined question in terms of participants, interventions, study design and ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4487964 Wed, 16 Feb 2011 00:00:00 +0100 4487964 http://www.medworm.com/index.php?rid=4481272&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntifibrinolytics-in-cardiac-surgical-patients-receiving-aspirin-a-systematic-review-and-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that antifibrinolytic agents were effective for reducing chest-tube drainage and transfusion requirements for low risk patients undergoing cardiac surgery who were receiving aspirin, but there was no benefit for adverse events. The authors' conclusions are reasonable and likely to be reliable, provided they are applied to a low risk population. CRD Commentary: There was a clearly stated review question and a number of appropriate databases were searched for studies with no language restrictions, reducing the risk of missing relevant studies. Methods were used to reduce error and bias in study selection, data extraction and quality assessment. It was appropriate to pool the trials in a meta-analysis.... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4481272 Tue, 15 Feb 2011 00:00:00 +0100 4481272 http://www.medworm.com/index.php?rid=4481271&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FRole-of-fluoroquinolones-in-the-primary-prophylaxis-of-spontaneous-bacterial-peritonitis-meta-analysis%2F The objectives and inclusion criteria of the review were clear and relevant sources were searched for published and unpublished studies, with no language restriction. Steps were taken to reduce the risk of reviewer bias and error in the processes of study selection and data extraction, by having more than one reviewer make decisions independently. It was unclear whether these precautions also applied to the process of validity assessment. While an appropriate tool was used to assess validity ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4481271 Tue, 15 Feb 2011 00:00:00 +0100 4481271 http://www.medworm.com/index.php?rid=4481270&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FRole-of-nonsteroidal-anti-inflammatory-drugs-in-the-prevention-of-post-ERCP-pancreatitis-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors' concluded that the prophylactic use of non-steroidal anti-inflammatory drugs can reduce the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography. Given some concerns about the reporting of the review process, the extent to which the authors' conclusions can be relied upon is unclear. CRD Commentary: This review addressed a clear question and the inclusion criteria were potentially reproducible for aspects of study design, participants, interventions and outcomes. The search strategy included relevant sources, but the restriction to published studies may mean that some data were missed, and publication bias could not be ruled out. An appropriate validity assessment was carried out, ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4481270 Tue, 15 Feb 2011 00:00:00 +0100 4481270 http://www.medworm.com/index.php?rid=4481269&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSystematic-review-glucose-control-and-cardiovascular-disease-in-type-2-diabetes%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review found that intensive glucose control reduced the risk for some cardiovascular disease outcomes in patients with type 2 diabetes (e.g. non-fatal myocardial infarction), but did not reduce the risk for cardiovascular death or all-cause mortality, and increased the risk for severe hypoglycaemia. As some participants were double-counted in the analyses, the authors' conclusions should be viewed with caution. [The intensive glucose treatments were: sulfonylurea or insulin; metformin; hypoglycaemic agents plus other drugs; gliclazide plus other drugs; and metformin plus rosiglitazone or insulin. ] CRD Commentary: The review question was supported by clear inclusion criteria for participants, intervention, outcome... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4481269 Tue, 15 Feb 2011 00:00:00 +0100 4481269 http://www.medworm.com/index.php?rid=4432054&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FClinical-benefit-of-steroid-use-in-patients-undergoing-cardiopulmonary-bypass-a-meta-analysis-of-randomized-trials%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This generally well-conducted review found some evidence of reductions in new-onset atrial fibrillation, post-operative bleeding and durations of intensive care unit and hospital stays for patients who underwent cardiopulmonary bypass surgery. On the basis of the results of the trials included in the review, the authors' conclusions reflected the evidence presented and are likely to be reliable. [Steroid treatment included dexamethasone, methylprednisolone, hydrocortisone and prednisolone in varying dosages and formulations.] CRD Commentary: The review addressed a clear question and had clearly stated inclusion criteria with respect to study design, participants, treatments and outcomes. The authors searched relevant ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4432054 Thu, 03 Feb 2011 00:00:00 +0100 4432054 http://www.medworm.com/index.php?rid=4432053&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEfficacy-of-antiglaucoma-fixed-combination-therapy-versus-unfixed-components-in-reducing-intraocular-pressure-a-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that fixed combination therapies were equally as safe and effective at lowering intraocular pressure as their individual components administered separately. The conclusions about efficacy are reasonable, but their reliability was dependant upon the appropriateness of the cut-off point used to establish equal effectiveness. The conclusions about equal safety were based on limited data. [The specific medications of interest were a beta-blocker plus one of travoprost, brimonidine tartrate, dorzolamide, bimatoprost and latanoprost.] CRD Commentary: This review had a clearly stated review question and inclusion criteria. A number of relevant databases were searched and attempts were made to identify un... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4432053 Thu, 03 Feb 2011 00:00:00 +0100 4432053 http://www.medworm.com/index.php?rid=4432052&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FThe-effects-of-Diane-35-and-metformin-in-treatment-of-polycystic-ovary-syndrome-an-updated-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review assessed whether Diane-35 could improve the treatment for polycystic ovary syndrome, with and without metformin. The authors concluded that Diane-35 was superior to metformin in reducing androgens, but was inferior in reducing insulin and did not improve hirsutism. There was no evidence of improved outcome for Diane-35 combined with metformin. The authors' conclusions appear to be reliable. [Diane-35 (35 ?g ethinyl oestradiol plus 2 mg cyproterone acetate)] CRD Commentary: The review question was clearly stated. The inclusion criteria was clear. Exclusion criteria were less clear and trials that reported unclear randomisation were not excluded. The search covered a broad range of printed and electronic mate... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4432052 Thu, 03 Feb 2011 00:00:00 +0100 4432052 http://www.medworm.com/index.php?rid=4376333&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FCochrane-review-suggests-caution-in-prescribing-statins-for-primary-prevention-among-people-at-low-cardiovascular-risk%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews The harms and benefits of statins for the primary prevention of cardiovascular disease (CVD) have been evaluated in a Cochrane review.   The literature [reference lists of previous systematic reviews, Cochrane Central Register of Controlled Trials (Issue 1, 2007), MEDLINE (2001 to March 2007) and EMBASE (2003 to March 2007)] was searched for RCTs with minimum duration of 1-year and follow-up of 6-months, in adults with no restrictions on their total, LDL or HDL cholesterol levels, and where ?10% had a history of CVD.   The outcomes analysed included:   . All cause mortality . Fatal and non-fatal CHD, CVD and stroke events . Combined endpoints (fatal and non-fatal CHD, CVD and st... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4376333 Thu, 20 Jan 2011 00:00:00 +0100 4376333 http://www.medworm.com/index.php?rid=4359601&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSystematic-review-proton-pump-inhibitors-for-the-treatment-of-gastroesophageal-reflux-in-infants%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The review evaluated the safety and effectiveness of proton pump inhibitors in the treatment of gastro-oesophageal reflux disease in infants and found limited evidence that omeprazole significantly reduced reflux. The review was generally well conducted. The authors' conclusion that there was insufficient evidence for the use of proton pump inhibitors for treatment of gastro-oesophageal reflux disease in infants seems reliable. CRD Commentary: The review addressed a well-defined question in terms of participants, interventions, study design and relevant outcomes. It was unfortunate that only two relevant RCTs were identified and that one of them was of preterm infants (which may be more vulnerable than infants born at te... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4359601 Mon, 17 Jan 2011 00:00:00 +0100 4359601 http://www.medworm.com/index.php?rid=4359600&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSecond-line-or-subsequent-systemic-therapy-for-recurrent-or-progressive-non-small-cell-lung-cancer-a-clinical-practice-guideline%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The review had a number of methodological weaknesses. The authors' conclusions about survival and quality benefits of docetaxel, pemetrexed and erlotinib were based on single studies per intervention and carried limited weight. The concluded effectiveness in second-line and subsequent therapies was from evidence that related to second-line therapies alone or mixed populations where the distribution of the effect was unknown. CRD Commentary: The review addressed a clearly stated research question and defined appropriate inclusion criteria, with the exception that no outcome measures were specified. The search strategy was adequate, but the exclusion of publications not in English left a possibility of language bias. Measu... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4359600 Mon, 17 Jan 2011 00:00:00 +0100 4359600 http://www.medworm.com/index.php?rid=4359599&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FA-systematic-review-and-meta-analysis-of-the-treatment-for-Barretts-esophagus%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that pharmacological therapy, antireflux surgery and endoscopic ablative techniques were promising in treating Barrett's oesophagus, but studies performed to date did not possess adequate power to assess reduction and prevention of progression to adenocarcinoma. The conclusions reflected the results presented, but due to potential sources of bias (language, publication and reviewer error) their reliability is uncertain. CRD Commentary: The review question was supported by inclusion criteria for study design, participants and outcomes. Relevant databases were searched; searches were restricted to published English-language articles, so the review may have been susceptible to language and pu... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4359599 Mon, 17 Jan 2011 00:00:00 +0100 4359599 http://www.medworm.com/index.php?rid=4341696&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FProphylactic-corticosteroids-do-not-prevent-post-ERCP-pancreatitis-a-meta-analysis-of-randomized-controlled-trials%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This well-conducted review evualted the effectiveness of corticosteroids for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. The authors' conclusion that prophylactic corticosteroids did not reduce the incidence of post-ERCP pancreatitis is likely to be reliable. [The corticosteroids included were methylprednisolone, hydrocortisone and prednisone.] CRD Commentary: The review addressed a clear research question supported by inclusion criteria for participants, intervention, outcomes and study design. Several electronic sources were searched but the authors did not report any attempts to identify unpublished studies (and funnel plot asymmetry suggested the presence of publicatio... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4341696 Thu, 13 Jan 2011 00:00:00 +0100 4341696 http://www.medworm.com/index.php?rid=4317203&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-other-than-anticoagulants-and-systemic-antibiotics-for-prevention-of-central-venous-catheter-related-infections-in-children-with-cancer%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Use of central venous catheters (CVC) in treatment of children with cancer is associated with infective complications. Current evidence-based guidelines to prevent catheter-related infections are mainly relevant to the adult population. They are not cancer (especially not childhood cancer) specific. Two existing Cochrane reviews have looked at prophylactic antibiotics and anticoagulants to prevent CVC-related infections.   Objectives The primary objective was to find which interventions, if any, were effective in preventing CVC-related infections in children with cancer. Further objectives were to examine the effectiveness of each intervention in the following subgroups: implanted versus external cat... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4317203 Thu, 06 Jan 2011 00:00:00 +0100 4317203 http://www.medworm.com/index.php?rid=4317202&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTreatment-for-inhalant-dependence-and-abuse%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Inhalants are being abused by large numbers of people throughout the world, particularly socio-economically disadvantaged children and adolescents. The neuropsychological effects of acute and chronic inhalant abuse include motor impairment, alterations in spontaneous motor activity, anticonvulsant effects, anxiolytic effects, sensory effects, and effects and learning, memory and operant behaviour (e.g., response rates and discriminative stimulus effects).   Objectives To search and determine risks, benefits and costs of a variety treatments for inhalant dependence or abuse.   Search strategy We searched MEDLINE (1966 - February 2010), EMBASE (Januray 2010) and Cochrane Central Register of ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4317202 Thu, 06 Jan 2011 00:00:00 +0100 4317202 http://www.medworm.com/index.php?rid=4317201&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntibiotic-prophylaxis-for-patients-undergoing-elective-laparoscopic-cholecystectomy%2F Source: No information given Area: Evidence > Disease Focused Reviews Background Cholecystectomy is a common surgical procedure. In the open cholecystectomy area, antibiotic prophylaxis showed beneficial effects, but it is not known if its benefits and harms are similar in laparoscopic cholecystectomy. Some clinical trials suggest that antibiotic prophylaxis may not be necessary in laparoscopic cholecystectomy.   Objectives To assess the beneficial and harmful effects of antibiotic prophylaxis versus placebo or no prophylaxis for patients undergoing elective laparoscopic cholecystectomy.   Search strategy We searched the The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4317201 Thu, 06 Jan 2011 00:00:00 +0100 4317201 http://www.medworm.com/index.php?rid=4317200&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntibiotics-for-meconium-stained-amniotic-fluid-in-labour-for-preventing-maternal-and-neonatal-infections%2F The objective of this review is to assess the efficacy and side effects of prophylactic antibiotics for MSAF during labour in preventing maternal and neonatal infections.   Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2010).   Selection criteria Randomized controlled trials (RCTs) comparing prophylactic antibiotics with placebo or no treatment during labour for women with MSAF.   ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4317200 Thu, 06 Jan 2011 00:00:00 +0100 4317200 http://www.medworm.com/index.php?rid=4317199&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FHormonal-therapy-in-advanced-or-recurrent-endometrial-cancer%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Endometrial cancer is a cancer of the lining of the womb and worldwide is the seventh most common cancer in women. Treatment with hormones is thought to be beneficial in patients with endometrial cancer.   Objectives To assess the indications, effectiveness and safety of hormone therapy for advanced or recurrent epithelial endometrial cancer.   Search strategy We searched the Cochrane Gynaecological Cancer Group Trials Register, MEDLINE, EMBASE up to May 2009 and and CENTRAL (Issue 2, 2009). We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies, and contacted experts in the field.   Selection criteria Randomised c... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4317199 Thu, 06 Jan 2011 00:00:00 +0100 4317199 http://www.medworm.com/index.php?rid=4312812&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-women-with-endometrioma-prior-to-assisted-reproductive-technology%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Endometriomata are cysts of endometriosis in the ovaries. As artificial reproductive technology (ART) cycles involve oocyte pickup from the ovaries, endometriomata may interfere with the outcome of ART.   Objectives To determine the effectiveness and safety of surgery, medical treatment, combination therapy or no treatment for improving reproductive outcomes among women with endometriomata, prior to undergoing ART cycles.   Search strategy The review authors searched: Cochrane Menstrual Disorders and Subfertility Group Specialised Register of trials, CENTRAL (The Cochrane Library), EMBASE, MEDLINE, PubMed, PsycINFO, CINAHL, DARE, trial registers for ongoing and registered trials, citation ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4312812 Wed, 05 Jan 2011 00:00:00 +0100 4312812 http://www.medworm.com/index.php?rid=4312811&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPain-relief-for-outpatient-hysteroscopy%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Hysteroscopy is increasingly performed in an outpatient setting. The primary reason for failure is pain. There is no consensus upon the routine use of analgesia during hysteroscopy.   Objectives The aim of the study was to compare the effectiveness of different types of pharmacological interventions for pain relief in patients undergoing hysteroscopy.   Search strategy A search of medical literature databases including PubMed, EMBASE, PsycINFO and CINHAL (to February 2010).   Selection criteria Randomised controlled trials (RCTs) investigating pharmacological interventions for pain relief during hysteroscopy were investigated.   Data collection and analysis Results fo... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4312811 Wed, 05 Jan 2011 00:00:00 +0100 4312811 http://www.medworm.com/index.php?rid=4312810&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FShort-term-treatment-with-proton-pump-inhibitors-H2-receptor-antagonists-and-prokinetics%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Approximately 25% of adults regularly experience heartburn, a symptom of gastro-oesophageal reflux disease (GORD). Most patients are treated empirically (without specific diagnostic evaluation e.g. endoscopy. Among patients who have an upper endoscopy, findings range from a normal appearance, mild erythema to severe oesophagitis with stricture formation. Patients without visible damage to the oesophagus have endoscopy negative reflux disease (ENRD). The pathogenesis of ENRD, and its response to treatment may differ from GORD with oesophagitis.   Objectives Summarise, quantify and compare the efficacy of short-term use of proton pump inhibitors (PPI), H2-receptor antagonists (H2RA) and prokinetics in... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4312810 Wed, 05 Jan 2011 00:00:00 +0100 4312810 http://www.medworm.com/index.php?rid=4312809&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FClomiphene-citrate-metformin-or-both-as-first-step-approach-in-treating-anovulatory-infertility%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review compared combination therapy with monotherapy (clomiphene citrate or metformin) for treatment of infertility in women with polycystic ovary syndrome (PCOS). The authors' conclusion that combination therapy offered no advantage and monotherapies were similarly effective reflected most of the data presented. Limitations in the review process and paucity of data mean that the conclusions should be viewed with caution. CRD Commentary: The review addressed a clearly stated research question and defined appropriate inclusion criteria. A thorough search of the literature was conducted to identify relevant studies and no language restrictions were applied. No searches for unpublished studies were reported. Measures t... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4312809 Wed, 05 Jan 2011 00:00:00 +0100 4312809 http://www.medworm.com/index.php?rid=4312808&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPenicillins-vs-trimethoprim-based-regimens-for-acute-bacterial-exacerbations-of-chronic-bronchitis-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that semisynthetic penicillin and trimethoprim-based regimens seemed to be equivalent for the treatment of acute bacterial exacerbation of chronic bronchitis. The authors' conclusions are reasonable, but they were based on limited evidence and may have limited generalisability to populations with antimicrobial resistance to Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis strains. [The penicillins investigated in the included studies were amoxicillin (most commonly) and pivampicillin and ampicillin. The comparators were trimethoprim alone or in combination with sulfamethoxazole or sulfadiazine. ] CRD Commentary: There was a clearly stated review question. A number of appr... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4312808 Wed, 05 Jan 2011 00:00:00 +0100 4312808 http://www.medworm.com/index.php?rid=4263027&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntibiotic-adjuvant-therapy-for-pulmonary-infection-in-cystic-fibrosis%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Cystic fibrosis is a multi-system disease characterised by the production of thick secretions causing recurrent pulmonary infection, often with unusual bacteria. This leads to lung destruction and eventually death through respiratory failure. There are no antibiotics in development that exert a new mode of action and many of the current antibiotics are ineffective in eradicating the bacteria once chronic infection is established. Antibiotic adjuvants - therapies that act by rendering the organism more susceptible to attack by antibiotics or the host immune system, by rendering it less virulent or killing it by other means, are urgently needed.   Objectives To determine if antibiotic adjuvants improv... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4263027 Wed, 15 Dec 2010 00:00:00 +0100 4263027 http://www.medworm.com/index.php?rid=4263026&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntibiotic-prophylaxis-for-patients-undergoing-elective-endoscopic-retrograde-cholangiopancreatography%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background The use of prophylactic antibiotics before endoscopic retrograde cholangiopancreatography (ERCP) is recommended by all major international gastroenterological societies, especially in the presence of an obstructed biliary system. Their use is intended to decrease or eliminate the incidence of complications following the procedure, namely cholangitis, cholecystitis, septicaemia, and pancreatitis.   Objectives To assess the benefits and harms of antibiotics before elective ERCP in patients without evidence of acute or chronic cholecystitis, or acute or chronic cholangitis, or severe acute pancreatitis.   Search strategy We searched The Cochrane Hepato-Biliary Group Controlled Trials Registe... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4263026 Wed, 15 Dec 2010 00:00:00 +0100 4263026 http://www.medworm.com/index.php?rid=4263025&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FDrugs-for-treatment-of-urinary-retention-after-surgery-in-adults%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Post-operative urinary retention, the inability to void following surgery despite a full bladder, is usually transitory but can be prolonged in some cases. It can lead to several complications including urinary tract infection, long term bladder dysfunction and kidney damage leading to chronic kidney disease. Catheterisation, generally regarded as the optimal management method, is associated with risks and so pharmacological treatment of post-operative urinary retention that could remove or reduce the need for catheterisation is desirable.   Objectives To assess the effectiveness of drugs for treatment of post-operative urinary retention either alone or as an adjunct to catheterisation.   ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4263025 Wed, 15 Dec 2010 00:00:00 +0100 4263025 http://www.medworm.com/index.php?rid=4263024&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPharmacological-interventions-for-pain-in-patients-with-temporomandibular-disorders%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Temporomandibular disorders (TMD) are a group of disorders affecting the temporomandibular joints and the muscles of mastication. TMDs are treated with a wide range of drugs. The extent to which the use of these drugs is based upon evidence is unknown.   Objectives To assess the effectiveness of pharmacological interventions both alone and in combination with non-pharmacological therapy in relieving pain in patients with chronic TMD.   Search strategy Electronic searches of the Cochrane Oral Health Group's Trials Register (2 August 2010), CENTRAL (The Cochrane Library 2010, Issue 3), MEDLINE via OVID (1950 to 2 August 2010), EMBASE via OVID (1980 to 2 August 2010) and CINAHL via EBSCO (1... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4263024 Wed, 15 Dec 2010 00:00:00 +0100 4263024 http://www.medworm.com/index.php?rid=4232189&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FLong-acting-insulin-analogues-for-diabetes-mellitus-meta-analysis-of-clinical-outcomes-and-assessment-of-cost-effectiveness%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: Long-acting insulin analogues (specifically insulin glargine and insulin detemir) were investigated for the treatment of diabetes mellitus. The authors found that long-acting insulin analogue use did not result in clinically important outcomes for all patients with diabetes mellitus. This review was generally well-conducted and the authors' conclusions are likely to be reliable. CRD Commentary: The research question was well defined and supported by inclusion criteria for participants, outcomes, interventions and study design. Published and unpublished sources were searched, reducing the possibility of publication bias (but this was not assessed). The authors did not specify whether language restrictions were used, so th... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4232189 Mon, 06 Dec 2010 00:00:00 +0100 4232189 http://www.medworm.com/index.php?rid=4232188&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FRole-of-chemotherapy-and-rituximab-for-treatment-of-posttransplant-lymphoproliferative-disorder-in-solid-organ-transplantation%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded, from limited evidence, that overall response rates for rituximab and/or chemotherapy for post-transplant lymphoproliferative disorder treatment after solid organ transplantation ranged from 50 to 100% and five-year survival was 60%. The authors' cautious conclusions appear to reflect the limited quantity and quality of the data, but their reliability is difficult to assess due to poor reporting. CRD Commentary: This review answered a research question, which lacked clarity in terms of outcome and intervention; study design was also broadly defined.  Only one database was searched for studies. Although other sources were searched, there may be a risk that some relevant data may have been missed... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4232188 Mon, 06 Dec 2010 00:00:00 +0100 4232188 http://www.medworm.com/index.php?rid=4218302&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEffects-of-renin-angiotensin-system-blockers-on-renal-outcomes-and-all-cause-mortality-in-patients-with-diabetic-nephropathy-an-updated-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review investigated angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in diabetic nephropathy. The authors concluded that treatment reduced the risk of end-stage renal disease and doubling of serum creatinine, but did not affect all-cause mortality. The reliability of the authors' conclusions is unclear as the quality of the included studies was not reported. CRD Commentary: The research question was supported by clear inclusion criteria for participants, intervention, study design and outcomes. Two relevant databases were searched. Searches were restricted to English-language studies and the authors did not report any attempts to find unpublished studies, which increased the ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4218302 Wed, 01 Dec 2010 00:00:00 +0100 4218302 http://www.medworm.com/index.php?rid=4218301&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEfficacy-of-oxaliplatin-plus-capecitabine-or-infusional-fluorouracilleucovorin-in-patients-with-metastatic-colorectal-cancer-a-pooled-analysis-of-randomized-trials%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors concluded that capecitabine plus oxaliplatin regimens reduced response rates compared to infusional fluorouracil plus oxaliplatin in metastatic colorectal cancer, and that treatments had similar effects on progression-free and overall survival. The authors' conclusions appeared to reflect the evidence, but the lack of reporting of review methods and trial quality make it difficult to be confident of their reliability. CRD Commentary: The review question was clearly stated and inclusion criteria were defined. Several relevant sources were searched. Some attempts were made to minimise publication bias; funnel plots showed no evidence of publication bias. It was not clear if any attempts were made to minimise l... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4218301 Wed, 01 Dec 2010 00:00:00 +0100 4218301 http://www.medworm.com/index.php?rid=4218300&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FRequirement-of-perioperative-stress-doses-of-corticosteroids-a-systematic-review-of-the-literature%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors concluded that patients who received therapeutic maintenance corticosteroids did not routinely require stress doses of corticosteroids when undergoing surgery, provided they received their usual daily dose of corticosteroids. The limitations to this review and the paucity of evidence suggested that a more caution conclusion may have been more appropriate. CRD Commentary: The review question was clearly stated and inclusion criteria appropriately defined. Several relevant sources were searched and no language restrictions were applied, but no attempts were made to minimise publication bias. Methods were used to minimise reviewer errors and bias in the selection of studies, but it was unclear whether similar st... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4218300 Wed, 01 Dec 2010 00:00:00 +0100 4218300 http://www.medworm.com/index.php?rid=4199464&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSystematic-review-comparative-effectiveness-and-harms-of-combinations-of-lipid-modifying-agents-and-high-dose-statin-monotherapy%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review compared high-dose statin monotherapy with combination therapy in adults at high-risk of coronary disease. The authors concluded that there was insufficient evidence to support the benefit of combination therapy for mortality, myocardial infarction, stroke, and revascularisation procedures. The authors' conclusion reflected the evidence presented, but the reliability is potentially compromised by search restrictions and unclear study quality. [he included statins were atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin. The majority of studies examined the statin-ezetimibe combination.] CRD Commentary: The review question was clear and was supported by detailed and potentially r... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4199464 Wed, 24 Nov 2010 00:00:00 +0100 4199464 http://www.medworm.com/index.php?rid=4199463&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FThe-ABCs-of-cardioprotection-in-dialysis-patients-a-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review found that it unclear whether cardioprotective medication such as angiotensin-converting enzyme (ACE) inhibitors, adrenergic beta antagonists (beta-blockers) and calcium channel blockers (CCBs) had beneficial effects in dialysis patients. The review suffered from some limitations, but the authors' conclusions were sufficiently cautious and likely to be reliable. CRD Commentary: The review addressed a broad objective supported by defined inclusion criteria. The literature search was adequate, but did not include specific attempts to locate unpublished studies and the review was limited to English-language studies, so there was a possibility of language and publication biases. Study quality was not assessed for... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4199463 Wed, 24 Nov 2010 00:00:00 +0100 4199463 http://www.medworm.com/index.php?rid=4199462&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEffects-of-low-dose-corticosteroids-on-the-bone-mineral-density-of-patients-with-rheumatoid-arthritis-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that low-dose corticosteroid treatment reduced bone mineral density in patients with rheumatoid arthritis. These conclusions were supported by the data presented, but should be interpreted with some caution due to a lack of details on the review methods. CRD Commentary: The review addressed a narrow, focused question supported by clearly defined inclusion criteria. The literature search was adequate, but the review was restricted to published studies and so there was a possibility of publication bias, which was addressed in the review. Study quality was assessed using appropriate criteria and the results of the quality assessment were clearly reported, but they were not considered in the synthesis o... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4199462 Wed, 24 Nov 2010 00:00:00 +0100 4199462 http://www.medworm.com/index.php?rid=4170852&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FThe-effectiveness-of-treatment-for-depressiondepressive-symptoms-in-adults-with-cancer-a-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded there was some evidence of effectiveness of pharmacological interventions for cancer patients with depression but there was a paucity of data on tolerability. Data was limited on the efficacy of psychotherapeutic interventions. The authors' cautious conclusions appropriately reflect the variable quality of the included trials. CRD Commentary: The review addressed a broad research question, encompassing a wide range of interventions. Several relevant sources were searched and attempts were made to locate unpublished studies, thus limiting the possibility of publication bias. However, restriction to English language studies may have resulted in the loss of some relevant data. Methods were used to mini... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4170852 Tue, 16 Nov 2010 00:00:00 +0100 4170852 http://www.medworm.com/index.php?rid=4170851&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FCombined-corticosteroid-and-antiviral-treatment-for-bell-palsy-a-systematic-review-and-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This well-conducted review concluded that corticosteroids are associated with a reduced risk of unsatisfactory recovery in Bell palsy. Also, there may be an additional benefit associated with the use of antiviral agents combined with corticosteroid treatment. These conclusions are likely to be reliable. CRD Commentary: The review question and inclusion criteria were clear. The search was extensive and included a systematic search for unpublished studies. These factors, together with the lack of language restrictions, reduced the chances that relevant studies were omitted. The authors reported using methods designed to reduce reviewer bias and error at all stages of the review process. An appropriate and thorough validity... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4170851 Tue, 16 Nov 2010 00:00:00 +0100 4170851 http://www.medworm.com/index.php?rid=4166326&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FOutcome-of-pharmacological-treatments-of-pathological-gambling-a-review-and-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors concluded that pharmacological interventions may be an adequate treatment alternative for pathological gambling. Given the unclear quality of included studies and the potential for error and bias in the review process, the authors conclusions should be treated with caution. CRD Commentary: The review addressed a clear question. Inclusion criteria for participants, intervention, outcomes and study design were well defined. Just two databases were searched for only English-language articles and the search appeared to be restricted to published articles, so language and publication biases may have been introduced. Publication bias was assessed, but the reviewers used a method that may have been unreliable. It wa... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4166326 Mon, 15 Nov 2010 00:00:00 +0100 4166326 http://www.medworm.com/index.php?rid=4161672&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FA-meta-analysis-of-stem-cell-mobilization-by-granulocyte-colony-stimulating-factor-in-the-treatment-of-acute-myocardial-infarction%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review found no evidence that adding granulocyte colony-stimulating factor (G-CSF) to standard therapy (percutaneous coronary intervention and medication) improved outcomes after a heart attack compared with standard therapy alone. The number of patients in included trials was too small to allow firm conclusions about the safety of G-CSF. The authors' conclusions and recommendations for research appear reliable. CRD Commentary: This review had clear inclusion criteria for participants, intervention, outcomes and study design. The authors searched a range of relevant databases without language restrictions and attempted to locate unpublished studies. Risk of publication bias was assessed. Validity was assessed using ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4161672 Fri, 12 Nov 2010 00:00:00 +0100 4161672 http://www.medworm.com/index.php?rid=4161671&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FRadioiodine-therapy-RAI-for-Graves-disease-GD-and-the-effect-on-ophthalmopathy-a-systematic-review%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors concluded that radioiodine therapy for Graves' disease increased the risk of ophthalmopathy compared with antithyroid drugs. Prednisolone prophylaxis was beneficial for patients with pre-existing ophthalmopathy. This review was generally well conducted. However, a degree of caution might be required in interpreting these conclusions, given the limited amount of data available for each comparison in the review. CRD Commentary: This review's inclusion criteria were clear. Several relevant databases were searched. Efforts were made to find both published and unpublished studies without language restriction, minimising the potential for both publication and language biases. Steps were taken to minimise bias by h... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4161671 Fri, 12 Nov 2010 00:00:00 +0100 4161671 http://www.medworm.com/index.php?rid=4161670&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FRanibizumab-and-pegaptanib-for-the-treatment-of-age-related-macular-degeneration-a-systematic-review-and-economic-evaluation%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review evaluated clinical and cost effectiveness of ranibizumab and pegaptanib for subfoveal choroidal neovascularisation associated with wet age-related macular degeneration. Patients with age-related macular degeneration of any type of lesion benefited from treatment with pegaptanib or ranibizumab on measures of visual acuity when compared with sham injection and/or photodynamic therapy. These conclusions are likely to be reliable. CRD Commentary: The inclusion criteria were clear for participants, intervention, outcomes and study design. Several sources of published and unpublished data were searched, which reduced the possibility of publication bias. Only English-language studies were included, which could have ... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4161670 Fri, 12 Nov 2010 00:00:00 +0100 4161670 http://www.medworm.com/index.php?rid=4148691&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FImpact-of-statins-on-risk-of-stroke-a-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors concluded that statin therapy significantly reduced the risk of developing all cerebrovascular events and ischaemic stroke, but was associated with a non-significant increased risk of haemorrhagic stroke. Overall, this review appeared to be well conducted, but it was difficult to assess the reliability of the findings without further information about the quality of the studies. CRD Commentary: The review addressed a clear question and was supported by clear inclusion criteria. Attempts to identify all relevant studies were undertaken by searching electronic databases and other sources, including conference abstracts. The authors did not find any publication bias. As the search was limited to English-languag... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4148691 Tue, 09 Nov 2010 00:00:00 +0100 4148691 http://www.medworm.com/index.php?rid=4148690&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FIndividual-patient-data-meta-analysis-of-allogeneic-peripheral-blood-stem-cell-transplant%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This individual patient data meta-analysis found that overall survival was significantly better and rates of relapse and relapse-related deaths were significantly lower for patients prescribed four-dose methotrexate and who received allogeneic peripheral blood stem cell transplants compared to bone marrow transplants. This project was conducted by a collaborative meta-analysis group and the conclusions seem reliable. CRD Commentary: The review addressed a clear question defined in terms of intervention, comparator, participants, outcomes and study design. Several relevant sources were searched. Efforts were made to reduce language bias. Some efforts were made to locate unpublished data. A collaborative group of trial inv... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4148690 Tue, 09 Nov 2010 00:00:00 +0100 4148690 http://www.medworm.com/index.php?rid=4115173&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FSIGN-guideline-on-diagnosis-and-management-of-psoriasis-and-psoriatic-arthritis-in-adults%2F Source: SIGN Area: Evidence > Disease Focused Reviews SIGN has published a guideline on the diagnosis and management of psoriasis and psoriatic arthritis (PsA) in adults. It covers early diagnosis of PsA, screening for comorbidities, assessment of disease severity, non-pharmacological treatment, psychological interventions, occupational health, topical treatment, phototherapy, systemic therapy, biologic treatment, referral pathways and the provision of patient information. (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4115173 Thu, 28 Oct 2010 23:00:00 +0100 4115173 http://www.medworm.com/index.php?rid=4115174&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FHealth-Technology-Assessment-HTA-Relapse-prevention-in-UK-Stop-Smoking-Services%2F Source: Health Technology Assessment (HTA) Area: Evidence > Disease Focused Reviews This Health Technology Assessment (HTA) assesses the effectiveness and cost-effectiveness of relapse prevention in NHS Stop Smoking Services (SSS).   The assessment was divided into four distinct phases:   . Qualitative research with a convenience sample of NHS SSS managers . Systematic review investigating the efficacy of relapse preventions interventions (RPIs) . Cost-effectiveness analysis . Further systematic review to derive the relapse curves for smokers receiving evidence-based treatment of the type delivered by the NHS SSS   Qualitative research with 16 NHS SSS managers indicated that there was no shared understanding of what relapse prevention m... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4115174 Wed, 27 Oct 2010 23:00:00 +0100 4115174 http://www.medworm.com/index.php?rid=4094443&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FAntithrombotic-therapy-following-bioprosthetic-aortic-valve-replacement%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review, of largely retrospective data, concluded that the optimal regimen for antithrombotic therapy in the first 90 days after tissue aortic valve replacement remained unclear because of methodological limitations in the included studies. Due to methodological flaws in the review process, the authors' conclusion may not be reliable. CRD Commentary: The review specified inclusion and exclusion criteria for participants and interventions, but not for study design or outcomes, to select studies from a comprehensive literature search. The search was restricted to English language publications and no attempts were made to locate unpublished material, so it is possible that some relevant studies may have been missed. The... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4094443 Wed, 20 Oct 2010 23:00:00 +0100 4094443 http://www.medworm.com/index.php?rid=4094442&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FCorticosteroid-treatment-of-severe-community-acquired-pneumonia%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review aimed to assess the evidence for adjunctive corticosteroids on the treatment of severe community-acquired pneumonia. The authors concluded that, given the paucity of information on their effects, systemic corticosteroids could not be recommended for adjunctive treatment of severe community-acquired pneumonia. Reporting limitations make it difficult to establish the reliability of the authors' conclusions. CRD Commentary: The review question was broadly defined in terms of participants and interventions of interest. Two electronic databases were searched with hand searching of bibliographies. However, it does not appear that efforts were made to identify unpublished or grey literature, so the potential for pub... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4094442 Wed, 20 Oct 2010 23:00:00 +0100 4094442 http://www.medworm.com/index.php?rid=4094441&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FEffects-of-different-chemotherapy-regimens-on-survival-for-advanced-cervical-cancer-systematic-review-and-meta-analysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: The authors found little evidence for survival benefits of different chemotherapy regimens in women with advanced cervical cancer. However, short-cycle lengths of cisplatin-based regimens, and concurrent chemotherapy and radiotherapy, yielded small benefits. The reliability of these conclusions is unclear, given the uncertain quality and variation within the included trials, and potential methodological flaws in the review process. CRD Commentary: The review addressed a clear question and undertook a comprehensive search for studies. The language restriction suggested that some articles may have been missed and the authors made no apparent attempt to identify unpublished studies. The validity of the included trials was n... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4094441 Wed, 20 Oct 2010 23:00:00 +0100 4094441 http://www.medworm.com/index.php?rid=4084876&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FUse-of-antibiotics-for-the-treatment-of-preterm-parturition-and-prevention-of-neonatal-morbidity-a-metaanalysis%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review found that antibiotics prolonged pregnancy and reduced neonatal morbidity in women with premature rupture of membranes at 34 weeks gestation or less. There was little evidence of benefit for women in pre-term labour at similar gestation. These findings should be interpreted with some caution, given the failure to assess study quality and the exclusion of unpublished studies. CRD Commentary: The review addressed a focused question supported by clearly defined inclusion criteria. The literature search was adequate but the review was limited to published studies, leaving it susceptible to publication bias, although this was assessed in the review. Appropriate steps were taken to minimise bias at all stages of th... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4084876 Tue, 19 Oct 2010 23:00:00 +0100 4084876 http://www.medworm.com/index.php?rid=4080845&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FOestrogens-for-treatment-or-prevention-of-pelvic-organ-prolapse-in-postmenopausal-women%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Pelvic organ prolapse is common and can be detected in up to 50% of parous women although many are asymptomatic. Oestrogen preparations are used to improve vaginal thinning (atrophy). It is possible that oestrogens, alone or in conjunction with other interventions, might prevent or assist in the management of pelvic organ prolapse, for example by improving the strength of weakened supporting structures.   Objectives To determine the effects of oestrogens or drugs with oestrogenic effects alone, or in conjunction with other treatments, both for prevention and treatment of pelvic organ prolapse.   Search strategy We searched the Cochrane Incontinence Group Specialised Register of trials (sea... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4080845 Mon, 18 Oct 2010 23:00:00 +0100 4080845 http://www.medworm.com/index.php?rid=4080844&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FParenteral-opioids-for-maternal-pain-relief-in-labour%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Parenteral opioids are used for pain relief in labour in many countries throughout the world.   Objectives To assess the acceptability, effectiveness and safety of different types, doses and modes of administration of parenteral opioids given to women in labour.   Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2010) and reference lists of retrieved studies.   Selection criteria We included randomised controlled trials examining the use of intramuscular or intravenous opioids (including patient controlled analgesia) for women in labour. We looked at studies comparing an opioid with placebo or another opioid.   Data coll... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4080844 Mon, 18 Oct 2010 23:00:00 +0100 4080844 http://www.medworm.com/index.php?rid=4080843&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FPharmacological-treatment-for-depression-during-opioid-agonist-treatment-for-opioid-dependence%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Lifetime prevalence of depression in subjects with opioid dependence is higher than in the general population (44-54% versus 16%) and represents a risk factor for morbidity and mortality. For patients on opioid agonist treatment, current prevalence rates of depression ranges between 10 and 30%, influencing negatively the outcome of the treatment.   Objectives To evaluate the efficacy and the acceptability of antidepressants for the treatment of depressed opioid dependents treated with opioid agonists.   Search strategy We searched Pubmed, EMBASE, CINAHL (to October 2009), CENTRAL (The Cochrane Library Cochrane Drug and Alcohol Group Specialised Register, issue 4, 2009), main electronic sou... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4080843 Mon, 18 Oct 2010 23:00:00 +0100 4080843 http://www.medworm.com/index.php?rid=4080842&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FTreatments-for-breast-engorgement-during-lactation%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Breast engorgement is a painful and unpleasant condition affecting large numbers of women in the early postpartum period. During a time when mothers are coping with the demands of a new baby it may be particularly distressing. Breast engorgement may inhibit the development of successful breastfeeding, lead to early breastfeeding cessation, and is associated with more serious illness, including breast infection.   Objectives To identify the best forms of treatment for women who experience breast engorgement.   Search strategy We identified studies for inclusion through the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2010).   Selection criteria Randomised a... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4080842 Mon, 18 Oct 2010 23:00:00 +0100 4080842 http://www.medworm.com/index.php?rid=4080841&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FNeuraminidase-inhibitors-for-treatment-and-prophylaxis-of-influenza-in-children-systematic-review-and-meta-analysis-of-randomised-controlled-trials%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This generally well-conducted review found that antiviral drugs (oseltamivir and zanamivir) shortened the duration of illness in children with seasonal influenza and reduced transmission to other children in the household, although these effects were small. The conclusions appear to be reliable for seasonal influenza, but their applicability to H1N1 pandemic influenza is uncertain. CRD Commentary: This review had clear inclusion criteria for study designs, interventions and participants. There were no specific inclusion criteria for outcomes and a broad range of outcomes were evaluated. Trials had to meet quality criteria to be included, but it was not reported how these criteria were applied or whether any trials were e... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4080841 Mon, 18 Oct 2010 23:00:00 +0100 4080841 http://www.medworm.com/index.php?rid=4076376&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FNitrofuran-based-regimens-for-the-eradication-of-Helicobacter-pylori-infection%2F Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review assessed furazolidone-based and nitrofurantoin-based regimens for the eradication of Helicobacter pylori infection and concluded that furazolidone-based primary triple therapies were less efficient than standard therapies. Furazolidone-based primary quadruple therapies were more efficient than furazolidone-based primary triple therapies. Given uncertainty over parts of the review process and study quality, the findings should be interpreted with caution. CRD Commentary: The review question was clear, but inclusion criteria were not reported for participants. The adequate literature search was done without language restrictions, thus restricting the potential for language bias. It was unclear whether unpublish... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4076376 Sun, 17 Oct 2010 23:00:00 +0100 4076376 http://www.medworm.com/index.php?rid=4076375&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FThe-effect-of-different-formulations-of-chlorhexidine-in-reducing-levels-of-mutans-streptococci-in-the-oral-cavity-a-systematic-review-of-the-literature%2F The objective of the review was clear and the inclusion criteria appeared adequate, but the rationale for some criteria was not explained (for example, the exclusion of studies that did not involve prior restorative treatment). The search involved only two databases and was restricted to published articles, which meant that some studies may have been missed and that the review was prone to publication bias. No formal test for publication bias was conducted. It was not stated whether steps were taken to minimise bias and error in the processes of study selection and data ... (Source: NeLM - Disease Focused Reviews) NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4076375 Sun, 17 Oct 2010 23:00:00 +0100 4076375 http://www.medworm.com/index.php?rid=4064001&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-the-treatment-of-borderline-ovarian-tumours%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background The safety of conservative surgery and the benefit of additional interventions after surgery for borderline ovarian tumours are unknown.   Objectives To evaluate the benefits and harm of different treatment modalities offered for borderline ovarian tumours.   Search strategy We searched the Cochrane Gynaecological Cancer Group Trials Register to 2009, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 4), MEDLINE and EMBASE to 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies.   Selection criteria Randomised controlled trials (RCTs) that compared different interv... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4064001 Tue, 12 Oct 2010 23:00:00 +0100 4064001 http://www.medworm.com/index.php?rid=4064000&cid=s_38937_49_f&fid=38937&url=http%3A%2F%2Fwww.nelm.nhs.uk%2Fen%2FNeLM-Area%2FEvidence%2FDisease-Focused-Reviews%2FInterventions-for-the-treatment-of-oral-cavity-and-oropharyngeal-cancer-chemotherapy%2F Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Oral cavity and oropharyngeal cancers are frequently described as part of a group of oral cancers or head and neck cancer. Treatment of oral cavity cancer is generally surgery followed by radiotherapy, whereas oropharyngeal cancers, which are more likely to be advanced at the time of diagnosis, are managed with radiotherapy or chemoradiation. Surgery for oral cancers can be disfiguring and both surgery and radiotherapy have significant functional side effects, notably impaired ability to eat, drink and talk. The development of new chemotherapy agents, new combinations of agents and changes in the relative timing of surgery, radiotherapy, and chemotherapy treatments may potentially bring about increases in both... NeLM - Disease Focused Reviews news http://www.medworm.com/rss/comments.php?id=4064000 Tue, 12 Oct 2010 23:00:00 +0100 4064000