Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

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.

Jun 1, 2015 Issue
Colchicine for Acute Gout
Low-quality evidence shows that low-dose colchicine (up to 1.8 mg over one hour) is an effective therapy for acute gout.

Jun 1, 2015 Issue
Aclidinium for Stable COPD
Aclidinium did not decrease all-cause mortality or exacerbations requiring oral steroids, antibiotics, or both. However, aclidinium decreased the number of patients with exacerbations requiring hospitalization and improved quality of life in those with stable COPD.

Apr 15, 2015 Issue
Cultural Competence Education for Health Care Professionals
Low-quality evidence suggests that training health care professionals in patient-centered communication improves the engagement of patients from culturally and linguistically diverse backgrounds in their health care. Interventions that were primarily educational appeared to be ineffective.

Apr 15, 2015 Issue
ACE Inhibitors vs. ARBs for Primary Hypertension
ACE inhibitors and ARBs have similar effects on cardiovascular outcomes and total mortality in head-to-head trials. However, slightly more adverse effects were noted in patients assigned to ACE inhibitor therapy.

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