From the Cochrane Library: Dietary supplements for established atopic eczema (Preprint)

2021 ◽  
Author(s):  
Madeline Adelman ◽  
Torunn Sivesind ◽  
Robert Dellavalle
Keyword(s):  
Dietary Supplements ◽  
Atopic Eczema ◽  
Treatment Options ◽  
Cochrane Review ◽  
Nutritional Supplements ◽  
Skin Condition ◽  
Cochrane Library ◽  
Long Term Effects ◽  
The Cochrane Library ◽  
Oral Supplements

UNSTRUCTURED Atopic eczema is a chronic inflammatory skin condition, affecting 5% to 20% of people worldwide, with no current cure. While there are many available treatment options that help improve atopic eczema, patients in whom these treatments did not work or who fear their long-term effects may look to diet for solutions. Nutritional supplements are a vast and growing industry, and patients often turn to oral supplements as complementary or alternative treatment options for a variety of health conditions. Nutritional supplements are not required to prove efficacy or safety before becoming available to consumers, as they are regulated by the FDA as foods instead of drugs. Given their growing popularity and industry characteristics, it is important for physicians to be knowledgeable about these ingredients in order to counsel patients. A 2012 Cochrane review, “Dietary supplements for established atopic eczema” offers a comprehensive review of evidence regarding popular dietary supplements used in atopic eczema.

scholarly journals Does Conservative Kidney Management Offer a Quantity or Quality of Life Benefit Compared to Dialysis? A Systematic Review

2021 ◽  
Author(s):  
Buur Louise Engelbrecht ◽  
Madsen Jens Kristian ◽  
Eidemak Inge ◽  
Krarup Elizabeth ◽  
Lauridsen Thomas Guldager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review was to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5.MethodsThe databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 treated with CKM or dialysis. The primary outcomes were mortality and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated, and forest plots conducted.ResultsTwenty-four primary studies, all observational, were identified. All studies except one reported an increased mortality in patients treated with CKM (pooled hazard ratio 0.53, 95% confidence interval 0.41-0.69). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis.ConclusionsIn general, patients with CKD5 live for a shorter time on CKM than on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

scholarly journals The Long-Term Structural Effect of Orthoses for Pediatric Flexible Flat Foot: A Systematic Review

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0014
Author(s):  
Jun Young Choi ◽  
Min Jin Kim ◽  
Jin Soo Suh
Keyword(s):  
Case Series ◽  
Structural Effect ◽  
Cochrane Library ◽  
Medial Longitudinal Arch ◽  
Long Term Effects ◽  
Flat Foot ◽  
Longitudinal Arch ◽  
Flat Feet ◽  
The Cochrane Library

Category: Midfoot/Forefoot Introduction/Purpose: Several conservative treatment methods, from intrinsic muscle exercises to orthoses, including insoles or specially designed shoes, have been introduced for pediatric flexible flat foot (PFFF). However, the structural effects of orthoses use remain unclear because the normal physiological maturation of the medial longitudinal arch cannot be ruled out. Methods: A comprehensive literature search using five databases, namely MEDLINE, the Cochrane Library, Scopus, the Web of Science, and EMBASE, was performed for pertinent articles published before March 30, 2018. Studies with quantitative data on the effects of the long-term use of orthoses for PFFF were included. The search strategy was adapted as appropriate for all other databases searched considering the differences in indexing terms and search syntax for each database. Results: All studies, including randomized controlled trials or prospective cohort studies, could not prove the estimated effects of orthoses on the medial longitudinal arch. However, they revealed that flexible flat feet in young children slowly improved with growth, regardless of the type of footwear used. However, three of four studies, which were case series, revealed that positive long-term effects could be achieved using orthoses. Conclusion: There is no strong evidence that the long-term use of orthoses improved the structural problem of PFFF.

Extracts from The Cochrane Library: Antibiotics for acute maxillary sinusitis

2008 ◽  
Vol 139 (4) ◽  
pp. 486-489 ◽  
Author(s):  
Martin J. Burton ◽  
Ronald B. Kuppersmith ◽  
Richard M. Rosenfeld
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Clinical Decision Making ◽  
Primary Care Setting ◽  
Maxillary Sinusitis ◽  
Cochrane Review ◽  
Clinical Decision ◽  
Neck Surgery ◽  
Cochrane Library ◽  
The Cochrane Library

The “Cochrane Corner” is a quarterly section in the Journal that highlights systematic reviews relevant to otolaryngology–head and neck surgery, with invited commentary to highlight implications for clinical decision making. This installment features a Cochrane Review entitled “Antibiotics for acute maxillary sinusitis,” which concludes a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms for more than seven days.

scholarly journals Effectiveness of Lomustine Combined With Bevacizumab in Glioblastoma: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xing Ren ◽  
Di Ai ◽  
Tong Li ◽  
Lei Xia ◽  
Lingzhi Sun
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Control Group ◽  
Subgroup Analyses ◽  
Group A ◽  
Group 2 ◽  
The Cochrane Library

Introduction: Despite surgical and chemotherapeutical treatment options, the prognosis for glioblastoma (GBM) remains poor. Some studies have found that using lomustine plus bevacizumab to treat GBM can prolong overall survival (OS) and progression-free survival (PFS). The aim of this study was to explore the efficacy of the two drugs in combination treatment of GBM using a meta-analysis of the existing literature to help settle the ongoing debate.Materials and Methods: PubMed, EMBASE, and the Cochrane Library were searched for the effectiveness of lomustine plus bevacizumab in GBM literature, updated on June 6, 2020. The main outcomes analyzed included PFS and OS; the effects of this drug combination on the 6-month PFS, which represents the percentage of patients who had PFS for 6 months, were also analyzed. All the data were pooled: OS and PFS with the mean difference (MD) and 6-month PFS with the risk ratio (RR). Because there were different control groups and dose groups, two subgroup analyses were run to ensure they were comparable. All statistical analyses were performed using the Review Manager Version 5.3 software.Results: Six clinical trials were identified which included 1,095 patients (treatment group: 516; control group: 579). The group treated with lomustine and bevacizumab showed an improvement in OS (MD =1.37; 95% CI, 0.49–2.25; p = 0.002), PFS (MD = 0.23; 95% CI, 0.13–0.34; p < 0.00001), and 6-month PFS (RR = 2.29; 95% CI, 1.43–3.65; p = 0.0005). Two subgroup analyses of the main outcome, OS, show that the results of Control group A (p = 0.01) and Dose group 2 (p = 0.003) are significantly different from those of the other control or dose groups.Conclusion: This study shows that lomustine and bevacizumab can effectively increase OS, PFS, and 6-month PFS in patients with GBM. The encouraging results of the lomustine and bevacizumab combination therapy for GBM should be studied in more clinical trials in the future.

scholarly journals Does conservative kidney management offer a quantity or quality of life benefit compared to dialysis? A systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Buur Louise Engelbrecht ◽  
Madsen Jens Kristian ◽  
Eidemak Inge ◽  
Krarup Elizabeth ◽  
Lauridsen Thomas Guldager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review was to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5. Methods The databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 who had chosen or were treated with either CKM or dialysis. The primary outcomes were mortality and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated, and forest plots conducted. Results Twenty-five primary studies, all observational, were identified. All studies reported an increased mortality in patients treated with CKM (pooled hazard ratio 0.47, 95 % confidence interval 0.34–0.65). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis. Conclusions In general, patients with CKD5 who have chosen or are on CKM live for a shorter time than patients who have chosen or are on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

From the Cochrane Library: Interventions for necrotizing soft tissue infections in adults (Preprint)

2021 ◽  
Author(s):  
Hadir Shakshouk ◽  
Camille Hua ◽  
Brandon L. Adler ◽  
Alex G. Ortega‐Loayza
Keyword(s):  
Soft Tissue ◽  
Cochrane Review ◽  
Cochrane Library ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infections ◽  
The Cochrane Library

UNSTRUCTURED Summary for the Cochrane review Interventions for necrotizing soft tissue infections in adults

scholarly journals What is a Cochrane review?

2011 ◽  
Vol 20 (3) ◽  
pp. 231-233 ◽  
Author(s):  
A. Cipriani ◽  
T. A. Furukawa ◽  
C. Barbui
Keyword(s):  
Cochrane Review ◽  
Cochrane Collaboration ◽  
Cochrane Library ◽  
Evidence Based ◽  
Editorial Process ◽  
For Profit ◽  
Not For Profit ◽  
Cochrane Reviews ◽  
Evidence Based Healthcare ◽  
The Cochrane Library

Systematic reviews carried out by Cochrane Collaboration (an international network of researchers belonging to this independent, not-for-profit organization) are recognized worldwide as the highest standard in evidence-based healthcare. The main reason is that Cochrane reviews follow a common and specific methodology to limit bias and random error. In this issue, we highlight the most important methodological features of Cochrane reviews, also reporting details on the editorial process to publish the review in the Cochrane Library.

Extracts from The Cochrane Library: Nasal saline irrigations for the symptoms of chronic rhinosinusitis

2007 ◽  
Vol 137 (4) ◽  
pp. 532-534 ◽  
Author(s):  
Martin J. Burton ◽  
Lee D. Eisenberg ◽  
Richard M. Rosenfeld
Keyword(s):  
Decision Making ◽  
Head And Neck ◽  
Chronic Rhinosinusitis ◽  
Systematic Reviews ◽  
Clinical Decision Making ◽  
Cochrane Review ◽  
Clinical Decision ◽  
Neck Surgery ◽  
Cochrane Library ◽  
The Cochrane Library

The “Cochrane Corner” is a quarterly section in the journal that highlights systematic reviews relevant to otolaryngology–head and neck surgery, with invited commentary to highlight implications for clinical decision-making. This installment features a Cochrane Review entitled “Nasal saline irrigations for the symptoms of chronic rhinosinusitis,” which shows that saline irrigations are well-tolerated and could be included as a treatment adjunct for the symptoms of chronic rhinosinusitis.

Meralgia paresthetica treated by injection, decompression, and neurectomy: a systematic review and meta-analysis of pain and operative outcomes

2021 ◽  
pp. 1-11
Author(s):  
Victor M. Lu ◽  
S. Shelby Burks ◽  
Rainya N. Heath ◽  
Tizeta Wolde ◽  
Robert J. Spinner ◽  
...  
Keyword(s):  
Pain Relief ◽  
Meta Analysis ◽  
Treatment Options ◽  
Outcome Data ◽  
Cochrane Library ◽  
Meralgia Paresthetica ◽  
Multiple Treatment ◽  
Operative Outcomes ◽  
Complete Pain Relief ◽  
The Cochrane Library

OBJECTIVEMeralgia paresthetica is caused by entrapment of the lateral femoral cutaneous nerve (LFCN) and often presents with pain. Multiple treatment options targeting the LFCN can be pursued to treat the pain should conservative measures fail, with the most common options being injection, neurolysis, and neurectomy. However, their efficacy in causing pain relief and their clinical outcomes have yet to be directly compared. The aim of this study was to interrogate the contemporary literature and quantitatively define how these options compare.METHODSThe electronic databases Ovid Embase, PubMed, SCOPUS, and the Cochrane Library were interrogated from inception to May 2020 following the PRISMA guidelines. Candidate articles were screened against prespecified criteria. Outcome data were abstracted and pooled by random-effects meta-analysis of proportions.RESULTSThere were 25 articles that satisfied all criteria, reporting outcomes for a total of 670 meralgia paresthetica patients, with 78 (12%) treated by injection, 496 (74%) by neurolysis, and 96 (14%) by neurectomy. The incidence of complete pain relief was 85% (95% CI 71%–96%) after neurectomy, 63% (95% CI 56%–71%) after neurolysis, and 22% (95% CI 13%–33%) after injection, which were all statistically different (p < 0.01). The incidence of revision procedures was 12% (95% CI 4%–22%) after neurolysis and 0% (95% CI 0%–2%) after neurectomy, which were significantly lower than 81% (95% CI 64%–94%) after injection (p < 0.01). The incidences of treatment complications were statistically comparable across all three treatments, ranging from 0% to 5% (p = 0.34).CONCLUSIONSThere are multiple treatment options to target pain in meralgia paresthetica. The incidence of complete pain relief appears to be the greatest among the 3 interventions after neurectomy, accompanied by the lowest incidence of revision procedures. These findings should help inform patient preference and expectations. Greater exploration of the anatomical rationale for incomplete pain relief after surgical intervention will assist in optimizing further surgical treatment for meralgia paresthetica.

scholarly journals Is There an Optimal Curative Option in HIV-Positive Men with Localized Prostate Cancer? A Systematic Review

2018 ◽  
Vol 12 (4) ◽  
pp. 169-176 ◽  
Author(s):  
John Baladakis ◽  
Marlon Perera ◽  
Damien Bolton ◽  
Nathan Lawrentschuk ◽  
Ahmed Adam
Keyword(s):  
Prostate Cancer ◽  
Treatment Options ◽  
Cochrane Library ◽  
Hiv Positive ◽  
Study Cohort ◽  
Management Algorithm ◽  
Search Terms ◽  
The Cochrane Library ◽  
Individualized Management ◽  
Surgical Treatments

Aims: We aimed to compare the outcome of curative treatment options in localised Prostate Cancer (PCa) amongst HIV positive (HIV+) men. Methods: A systematic search of the Cochrane Library of Systematic Reviews, the Scopus and PubMed databases was performed (January 1995 to November 2015) using pre-determined search terms. Outcome measures for comparison included the rate of biochemical failure (BCF), survival benefit and complications. Results: A total of 14 eligible articles were identified for inclusion, representing a total of 202 HIV+ men with PCa. Radical Prostatectomy was performed in 40/153 compared to 109/153 patients undergoing alternative (non-surgical) treatments options. Only 3 studies compared outcomes within their respective study cohort. One study (n = 10) reported BCF results with 1/2 BCF patient in the surgical arm vs. 1/8 BCF positive patients in the non-surgical arm (mean 46 months follow-up), while two other studies reported no occurrences of BCF within both arms of their studies. Conclusion: Due to paucity in the literature, there is insufficient evidence to support a certain treatment modality arm specifically for HIV+ men with localized PCa. An individualized management algorithm seems feasible within this cohort, until more definitive studies are performed.

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