Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Dec 1, 2015 Issue
Psychological Interventions for Medically Unexplained Physical Symptoms
Psychological therapy, specifically cognitive behavior therapy (CBT), has been shown to reduce the severity of medically unexplained physical symptoms in patients with somatoform disorders. The effect is small to moderate in magnitude, but in these studies CBT was as acceptable as usual care to patients.

Dec 1, 2015 Issue
Chewing Gum for Postoperative Recovery of Gastrointestinal Function
Having patients chew gum reduces the time to first flatus and time to first bowel movement, as well as the length of hospitalization by about half a day.

Nov 1, 2015 Issue
Interventions Aimed at Increasing Childhood Vaccination Rates
Community discussions, community meetings, and information campaigns may increase immunization uptake in areas with only moderate vaccine use. There is no clear evidence to guide face-to-face educational interventions, and the impact of face-to-face interventions is uncertain in areas where immunization use is already relatively high.

Nov 1, 2015 Issue
Exercise for Osteoarthritis of the Knee
Land-based exercise programs reduce knee pain and improve quality of life and physical function following treatment in patients with knee osteoarthritis.

Oct 1, 2015 Issue
Calcium Supplementation for Preventing Hypertensive Disorders in Pregnancy
High-dose calcium supplementation (i.e., at least 1,000 mg per day) during pregnancy reduces the risk of developing hypertension and preeclampsia. The most significant risk reduction occurs in women at risk of hypertensive disorders and those with low-calcium diets.

Oct 1, 2015 Issue
Point-of-Care C-Reactive Protein Testing to Help Guide Treatment of Acute Respiratory Infections
Point-of-care C-reactive protein (CRP) testing used as an adjunct to a physician's clinical examination can modestly reduce antibiotic use. Measurement of CRP to guide antibiotic prescription does not appear to affect the duration of illness or recovery, although one study suggests that it increases the risk of hospitalization.

Sep 1, 2015 Issue
Tricyclic Antidepressants for the Treatment of ADHD in Children and Adolescents
TCAs, specifically desipramine and nortriptyline (Pamelor), are superior to placebo at reducing ADHD symptoms in the short term (two to six weeks); however, the quality of evidence is low. Increased heart rate and diastolic blood pressure may be noted with treatment.

Sep 1, 2015 Issue
Pharmacologic Therapy for Gastroesophageal Reflux Disease in Children
Among infants younger than 12 months diagnosed with GERD, weak evidence supports the use of proton pump inhibitors (PPIs) and histamine H2 antagonists. Among children 12 months and older, studies have shown moderate benefit from PPIs and weak benefit from H2 antagonists for providing symptomatic relief and/or improving histologic or pH indices of disease.

Aug 1, 2015 Issue
The Epley Maneuver for Treatment of Benign Paroxysmal Positional Vertigo
Treatment with the Epley maneuver resolves benign paroxysmal positional vertigo better than sham therapy or control. Minor adverse effects are uncommon.

Jul 1, 2015 Issue
The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms
Based on low-quality evidence, levetiracetam was found to be ineffective for the treatment of chronic neuropathic pain symptoms. Moreover, patients who were taking levetiracetam experienced adverse effects at a significantly higher rate than those who were taking placebo.

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