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https://www.readbyqxmd.com/read/28530786/morphine-for-chronic-neuropathic-pain-in-adults
#1
REVIEW
Tess E Cooper, Junqiao Chen, Philip J Wiffen, Sheena Derry, Daniel B Carr, Dominic Aldington, Peter Cole, R Andrew Moore
BACKGROUND: Neuropathic pain, which is caused by a lesion or disease affecting the somatosensory system, may be central or peripheral in origin. Neuropathic pain often includes symptoms such as burning or shooting sensations, abnormal sensitivity to normally painless stimuli, or an increased sensitivity to normally painful stimuli. Neuropathic pain is a common symptom in many diseases of the nervous system. Opioid drugs, including morphine, are commonly used to treat neuropathic pain...
May 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28513067/interventions-for-cutaneous-molluscum-contagiosum
#2
REVIEW
Johannes C van der Wouden, Renske van der Sande, Emma J Kruithof, Annet Sollie, Lisette Wa van Suijlekom-Smit, Sander Koning
BACKGROUND: Molluscum contagiosum is a common skin infection that is caused by a pox virus and occurs mainly in children. The infection usually resolves within months in people without immune deficiency, but treatment may be preferred for social and cosmetic reasons or to avoid spreading the infection. A clear evidence base supporting the various treatments is lacking.This is an update of a Cochrane Review first published in 2006, and updated previously in 2009. OBJECTIVES: To assess the effects of specific treatments and management strategies, including waiting for natural resolution, for cutaneous, non-genital molluscum contagiosum in people without immune deficiency...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28509674/evidence-for-more-intensive-cholesterol-lowering
#3
Handrean Soran, See Kwok, Safwaan Adam, Jan Hoong Ho, Paul N Durrington
PURPOSE OF REVIEW: In randomized clinical trials, reduction in cardiovascular disease (CVD) risk with cholesterol-lowering drugs correlates with the LDL cholesterol decrease. However, because the majority have investigated a fixed statin dose, current guidelines disagree about the use of statin dose titration or non-statin adjunctive cholesterol-lowering drugs. RECENT FINDINGS: We conducted a meta-analysis of all randomized controlled trials with CVD end-points, comparing two intensities of lipid-lowering regimens within the same population, using varying statins doses and/or potency, ezetimibe or PCSK9 inhibitors and compared the observed number of patients needed to be treated for 10 years to prevent one CVD event (NNT) with NNT predicted from trials of predominantly single-dose statin...
May 15, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28497864/valbenazine-for-tardive-dyskinesia-a-systematic-review-of-the-efficacy-and-safety-profile-for-this-newly-approved-novel-medication-what-is-the-number-needed-to-treat-number-needed-to-harm-and-likelihood-to-be-helped-or-harmed
#4
REVIEW
Leslie Citrome
OBJECTIVE: The objective of this systematic review was to describe the efficacy, tolerability, and safety of valbenazine for the treatment of tardive dyskinesia (TD). DATA SOURCES: The pivotal registration trials were accessed by querying http://www.ncbi.nlm.nih.gov/pubmed/ and http://www.clinicaltrials.gov, for the search terms 'valbenazine' OR 'NBI-98854', and by also querying the EMBASE (Elsevier) commercial database for clinical poster abstracts, and by asking the manufacturer for copies of posters presented at congresses...
May 12, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28497473/topical-analgesics-for-acute-and-chronic-pain-in-adults-an-overview-of-cochrane-reviews
#5
REVIEW
Sheena Derry, Philip J Wiffen, Eija A Kalso, Rae F Bell, Dominic Aldington, Tudor Phillips, Helen Gaskell, R Andrew Moore
BACKGROUND: Topical analgesic drugs are used for a variety of painful conditions. Some are acute, typically strains or sprains, tendinopathy, or muscle aches. Others are chronic, typically osteoarthritis of hand or knee, or neuropathic pain. OBJECTIVES: To provide an overview of the analgesic efficacy and associated adverse events of topical analgesics (primarily nonsteroidal anti-inflammatory drugs (NSAIDs), salicylate rubefacients, capsaicin, and lidocaine) applied to intact skin for the treatment of acute and chronic pain in adults...
May 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28486879/a-brief-treatment-for-fear-of-heights
#6
Bruce Arroll, Suzanne M Henwood, Fred I Sundram, Douglas W Kingsford, Vicki Mount, Steve P Humm, Henry B Wallace, Avinesh Pillai
Objective To assess the effectiveness of a novel imaginal intervention for people with acrophobia. Methods The design was a randomized controlled trial with concealed randomization and blinded to other participants' intervention. The intervention was a single novel imaginal intervention session or a 15-min meditation. The setting was in Auckland, New Zealand. The participants were a convenience sample of the public with a score >29 on the Heights Interpretation Questionnaire (HIQ), a questionnaire validated against actual height exposure...
January 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28481462/biologics-or-tofacitinib-for-people-with-rheumatoid-arthritis-naive-to-methotrexate-a-systematic-review-and-network-meta-analysis
#7
REVIEW
Jasvinder A Singh, Alomgir Hossain, Amy S Mudano, Elizabeth Tanjong Ghogomu, Maria E Suarez-Almazor, Rachelle Buchbinder, Lara J Maxwell, Peter Tugwell, George A Wells
BACKGROUND: Biologic disease-modifying anti-rheumatic drugs (biologics) are highly effective in treating rheumatoid arthritis (RA), however there are few head-to-head biologic comparison studies. We performed a systematic review, a standard meta-analysis and a network meta-analysis (NMA) to update the 2009 Cochrane Overview. This review is focused on the adults with RA who are naive to methotrexate (MTX) that is, receiving their first disease-modifying agent. OBJECTIVES: To compare the benefits and harms of biologics (abatacept, adalimumab, anakinra, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab) and small molecule tofacitinib versus comparator (methotrexate (MTX)/other DMARDs) in people with RA who are naive to methotrexate...
May 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28459774/chemoprophylaxis-for-venous-thromboembolism-in-operative-treatment-of-fractures-of-the-tibia-and-distally-a-systematic-review-and-meta-analysis
#8
Joseph T Patterson, Saam Morshed
OBJECTIVES: Clinical practice has shifted from therapeutic anticoagulation of any lower extremity venous thromboembolism (VTE) to only thromboses with risk of proximal extension or embolization - clinically important VTE (CIVTE). Isolated operative fractures of the tibia and distally are associated with low-to-intermediate VTE risk and there is wide variability in the choice to anticoagulate as well as anticoagulant. We sought to evaluate the role for chemoprophylaxis of VTE and CIVTE in these injuries by meta-analysis of Level I evidence...
April 25, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28448754/clinical-evaluation-of-cost-efficacy-of-drugs-for-treatment-of-osteoporosis-a-meta-analysis
#9
Stewart G Albert, Supraja Reddy
OBJECTIVE: To assess the cost efficacy of available regimens for therapy of osteoporosis as defined as the cost time's number need to treat to prevent one fracture. PATIENTS AND METHODS: Existing meta-analyses were supplemented through electronic databases SCOPUS and PubMED between 2013 (a date overlapping the latest meta-analyses) and March 2016. Primary references included all randomized controlled trials of anti-osteoporotic drugs versus comparators using search terms "osteoporosis", "random" and "trial"...
April 27, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437598/the-potential-implications-of-using-disability-free-survival-and-number-needed-to-suffer-as-outcome-measures-for-neonatal-intensive-care
#10
Per-Arne Lönnqvist
The use of mortality and surrogate makers to determine outcomes after advanced medical treatment has been questioned, because often these dimensions do not agree with what both many medical staff and laypeople judge as adequate outcome measures. That is why Myles et al introduced the more adequate dimension of disability free survival (1-3). Furthermore, the suffering of other patients that is associated with one single individual having a good outcome has been discussed and the suggested term for this is the number needed to suffer (4), which reflects the similar terms of number needed to treat and number needed to harm...
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28436019/antibiotic-therapy-for-pelvic-inflammatory-disease
#11
REVIEW
Ricardo F Savaris, Daniele G Fuhrich, Rui V Duarte, Sebastian Franik, Jonathan Ross
BACKGROUND: Pelvic inflammatory disease (PID) is an infection that affects 4% to 12% of young women, and is one of the most common causes of morbidity in this age group. The main intervention for acute PID is the use of broad-spectrum antibiotics which cover Chlamydia trachomatis, Neisseria gonorrhoeae, and anaerobic bacteria, administered intravenously, intramuscularly, or orally. In this review, we assessed the optimal treatment regimen for PID. OBJECTIVES: To assess the effectiveness and safety of antibiotic regimens used to treat pelvic inflammatory disease...
April 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28435487/randomized-trial-of-adding-parenteral-acetaminophen-to-prochlorperazine-and-diphenhydramine-to-treat-headache-in-the-emergency-department
#12
Stefan H Meyering, Ryan W Stringer, Matthew K Hysell
INTRODUCTION: Headaches represent over three million emergency department (ED) visits per year, comprising 2.4% of all ED visits. There are many proposed methods and clinical guidelines of treating acute headache presentations. However, data on intravenous acetaminophen usage in these settings are lacking. In this study, we sought to determine the efficacy of intravenous (IV) acetaminophen as an adjunct to a standard therapy for the treatment of patients who present to the ED with a chief complaint of "headache...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28423145/brief-behavioral-therapy-for-pediatric-anxiety-and-depression-in-primary-care-a-randomized-clinical-trial
#13
V Robin Weersing, David A Brent, Michelle S Rozenman, Araceli Gonzalez, Megan Jeffreys, John F Dickerson, Frances L Lynch, Giovanna Porta, Satish Iyengar
Importance: Anxiety and depression affect 30% of youth but are markedly undertreated compared with other mental disorders, especially in Hispanic populations. Objective: To examine whether a pediatrics-based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care. Design, Setting, and Participants: This 2-center randomized clinical trial with masked outcome assessment conducted between brief behavioral therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8...
April 19, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28420629/dexamethasone-versus-standard-treatment-for-postoperative-nausea-and-vomiting-in-gastrointestinal-surgery-randomised-controlled-trial-dreams-trial
#14
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objectives To determine whether preoperative dexamethasone reduces postoperative vomiting in patients undergoing elective bowel surgery and whether it is associated with other measurable benefits during recovery from surgery, including quicker return to oral diet and reduced length of stay.Design Pragmatic two arm parallel group randomised trial with blinded postoperative care and outcome assessment.Setting 45 UK hospitals.Participants 1350 patients aged 18 or over undergoing elective open or laparoscopic bowel surgery for malignant or benign pathology...
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28412467/magnitude-and-direction-of-missing-confounders-had-different-consequences-on-treatment-effect-estimation-in-propensity-score-analysis
#15
Tri-Long Nguyen, Gary S Collins, Jessica Spence, Charles Fontaine, Jean-Pierre Daurès, Philip J Devereaux, Paul Landais, Yannick Le Manach
OBJECTIVE: Propensity score (PS) analysis allows an unbiased estimate of treatment effects but assumes that all confounders are measured. We assessed the impact of omitting confounders from a PS analysis on clinical decision making. STUDY DESIGN AND SETTING: We conducted Monte Carlo simulations on hypothetical observational studies based on virtual populations and on the population from a large randomized trial (CRASH-2). In both series of simulations, PS analysis was conducted with all confounders and with omitted confounders, which were defined to have different strengths of association with the outcome and treatment exposure...
April 12, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28408193/imipramine-versus-placebo-for-multiple-functional-somatic-syndromes-stress-3-a-double-blind-randomised-study
#16
Johanne L Agger, Andreas Schröder, Lise K Gormsen, Jens S Jensen, Troels S Jensen, Per K Fink
BACKGROUND: Functional somatic syndromes, including chronic fatigue syndrome or irritable bowel syndrome, often co-exist. Treatment guidelines supported by high quality evidence exist for most functional somatic syndromes, but are lacking for multiple comorbid functional somatic syndromes. We aimed to assess the effect of the tricyclic antidepressant, imipramine, in patients with multiple functional somatic syndromes defined by the criteria for multiorgan bodily distress syndrome, a unifying diagnosis that encompasses most functional somatic syndromes and somatoform disorders...
May 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28405705/-cost-effectiveness-of-gnrh-antagonists-in-patients-with-prostate-cancer-and-cardiovascular-risk-comparative-analysis-against-leuprorelin-by-the-number-needed-to-treat
#17
D Anderson, J Lehmann, T Ecker, S Vosgerau, V Donatz
BACKGROUND: Recent studies suggest that androgen deprivation therapy (ADT) is associated with increased cardiovascular (CV) risk for patients with hormone-sensitive prostate cancer (PCa) and pre-existing CV disease. This risk seems to be different for the gonadotropin-releasing hormone (GnRH) agonists leuprolide and goserelin and GnRH antagonists, whereas the slightly more expensive GnRH antagonist shows a beneficial risk profile. The present study assesses the cost effectiveness of degarelix compared to leuprolide for PCa patients with increased CV risk...
April 12, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28402756/effectiveness-of-manual-therapy-and-stretching-for-baseball-players-with-shoulder-range-of-motion-deficits
#18
Lane B Bailey, Charles A Thigpen, Richard J Hawkins, Paul F Beattie, Ellen Shanley
BACKGROUND: Baseball players displaying deficits in shoulder range of motion (ROM) are at increased risk of arm injury. Currently, there is a lack of consensus regarding the best available treatment options to restore shoulder ROM. HYPOTHESIS: Instrumented manual therapy with self-stretching will result in clinically significant deficit reductions when compared with self-stretching alone. STUDY DESIGN: Controlled laboratory study. METHODS: Shoulder ROM and humeral torsion were assessed in 60 active baseball players (mean age, 19 ± 2 years) with ROM deficits (nondominant - dominant, ≥15°)...
April 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28402497/systematic-review-of-safety-and-cost-effectiveness-of-venous-thromboembolism-prophylaxis-strategies-in-patients-undergoing-craniotomy-for-brain-tumor
#19
Hanna Algattas, Dushyant Damania, Ian DeAndrea-Lazarus, Kristopher T Kimmell, Nicholas F Marko, Kevin A Walter, G Edward Vates, Babak S Jahromi
BACKGROUND: Studies have evaluated various strategies to prevent venous thromboembolism (VTE) in neuro-oncology patients, without consensus. OBJECTIVE: To perform a systematic review with cost-effectiveness analysis (CEA) of various prophylaxis strategies in tumor patients undergoing craniotomy to determine the safest and most cost-effective prophylaxis regimen. METHODS: A literature search was conducted for VTE prophylaxis in brain tumor patients...
April 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28400629/biostatistics-series-module-8-assessing-risk
#20
Avijit Hazra, Nithya Gogtay
In observational studies, as well as in interventional ones, it is frequently necessary to estimate risk that is the association between an observed outcome or event and exposure to one or more factors that may be contributing to the event. Understanding incidence and prevalence are the starting point in any discussion of risk assessment. Incidence rate uses person-time as the denominator rather than a simple count. Ideally, rates and ratios estimated from samples should be presented with their corresponding 95% confidence intervals (CIs)...
March 2017: Indian Journal of Dermatology
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