Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Feb 1, 2018 Issue
Effectiveness of Skin-to-Skin Care for Procedure-Related Pain in Newborns
Skin-to-skin care, also known as kangaroo care, effectively reduces physiologic and behavioral measures of pain in neonates during painful procedures and has no identified adverse effects. Infants who received skin-to-skin care during painful procedures had a heart rate of 10.8 beats per minute less, cried for 34 fewer seconds, and had reduced pain scores immediately following the procedure compared with infants who did not receive skin-to-skin care.

Feb 1, 2018 Issue
Injected Corticosteroids for Plantar Heel Pain
There is low-quality evidence that corticosteroid injections slightly reduce heel pain at one month, but they make no significant difference beyond that time. Patients treated with corticosteroid injections were less likely to experience treatment failureā€”a designation that was defined differently between studies (number needed to treat [NNT] = 3). Injections do not appear to provide any functional benefits.

Jan 1, 2018 Issue
Effectiveness of Moisturizers in the Treatment of Patients with Eczema
Moisturizers decrease the rate of eczema flare-ups by 3.7 times vs. no treatment (number needed to treat [NNT] = 4), as well as the amount of topical corticosteroids used per eczema flare-up (9.3 g less). Adverse effects are minimal.

Jan 1, 2018 Issue
Dietary Interventions for Recurrent Abdominal Pain in Childhood
Probiotics relieve pain in children with recurrent abdominal pain in the short term (number needed to treat [NNT] = 8). There is no convincing evidence that fiber supplements improve pain in children with recurrent abdominal pain.

Dec 1, 2017 Issue
Oral Rehydration Solutions for the Treatment of Acute Watery Diarrhea
Oral rehydration solutions are distinguished by high or low osmolarity and by whether they are made with complex (i.e., polymer) or simple (i.e., glucose) carbohydrates. When oral rehydration solutions with high osmolarity (310 mOsm per L or greater) are compared, polymer-based solutions may result in lower stool output in the first 24 hours and shorter duration of diarrhea than glucose-based solutions.

Nov 1, 2017 Issue
Topical NSAIDs for Chronic Musculoskeletal Pain in Adults
Topical diclofenac and ketoprofen are slightly more effective than placebo for relieving chronic pain associated with osteoarthritis in adults. Evidence is lacking to determine the effectiveness of topical NSAIDs compared with oral NSAIDs.

Nov 1, 2017 Issue
Interventions for Tobacco Cessation in Patients Being Treated for or Recovering from Substance Use Disorders
Pharmacotherapy alone and pharmacotherapy plus counseling are effective for tobacco cessation among patients being treated for or recovering from alcohol and substance use disorders. Counseling interventions without pharmacotherapy are not effective for tobacco cessation among patients in treatment for or recovery from substance use disorders.

Oct 1, 2017 Issue
Yoga for Cancer-Related Symptoms in Women with Breast Cancer
Yoga improves health-related quality of life, reduces sleep disturbances, and decreases fatigue in the short term (up to 12 weeks) among women diagnosed with breast cancer who have completed cancer-related treatment or are receiving cancer treatment compared with no intervention.

Oct 1, 2017 Issue
Laxatives for the Management of Childhood Constipation
Polyethylene glycol (PEG) is superior to placebo (mean difference [MD] = 2.61 more stools per week; 95% confidence interval [CI], 1.15 to 4.08), lactulose (MD = 0.70; 95% CI, 0.10 to 1.31), and milk of magnesia (MD = 0.69; 95% CI, 0.48 to 0.89) at increasing the number of bowel movements per week at two to 12 weeks.

Sep 1, 2017 Issue
Vitamin D for the Management of Asthma
Despite the authors' caution that further data are needed to clarify the role of vitamin D in care, this Cochrane review found that its use reduces the average number of asthma exacerbations requiring corticosteroid treatment from 0.44 to 0.28 per person per year.

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