AFP DEPARTMENT COLLECTION

Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Jun 1, 2018 Issue
Cerebrospinal Fluid Biomarkers for Detection of Alzheimer Disease in Patients with Mild Cognitive Impairment
There is insufficient evidence to support the routine use of cerebrospinal fluid (CSF) biomarkers for the detection of progressive dementias in patients with mild cognitive impairment (MCI). These tests carry the risk of overdiagnosis of dementia and, therefore, overtreatment.


Jun 1, 2018 Issue
Atypical Antipsychotics for Disruptive Behavior Disorders in Children and Adolescents
Risperidone reduces measures of aggression and improves conduct in children with disruptive behavior disorders; however, only short-term use is recommended. Weight gain of 2 to 2.5 kg (4.4 to 5.5 lb) is common. There is insufficient evidence to evaluate the benefits of other antipsychotics.


May 1, 2018 Issue
Antiepileptic Drug Monotherapy for Epilepsy
In patients with partial-onset (focal) seizures, levetiracetam (Keppra), lamotrigine (Lamictal), and carbamazepine (Tegretol) were associated with the longest time to treatment withdrawal (i.e., the recommended patient-oriented outcome measure that balances tolerability with effectiveness).


May 1, 2018 Issue
Effectiveness and Safety of Celecoxib for the Treatment of Rheumatoid Arthritis
Compared with placebo, celecoxib improves pain (number needed to treat [NNT] = 4) and clinical symptoms (NNT = 7), but it has no effect on physical function in patients with RA.


Apr 1, 2018 Issue
Use of Niacin for Primary or Secondary Prevention of Cardiovascular or Cerebrovascular Events
Prescription niacin (nicotinic acid, vitamin B3) does not reduce myocardial infarctions, strokes, or overall mortality when used for primary or secondary prevention.


Apr 1, 2018 Issue
DPP-4 Inhibitors and GLP-1 Receptor Agonists for Prevention or Delay of Type 2 Diabetes Mellitus and Associated Complications
There is only limited-quality evidence that at-risk patients taking GLP-1 receptor agonists are less likely to progress to diabetes (number needed to treat [NNT] = 23). Serious adverse events were more likely in patients taking GLP-1 receptor agonists than in patients taking placebo (number needed to harm [NNH] = 42).


Mar 1, 2018 Issue
Effect of Pacifier Use on Duration of Breastfeeding
In healthy, full-term, breastfeeding infants, there is moderate evidence that unrestricted pacifier use, started at birth or after lactation has been established, does not decrease the likelihood of continued exclusive or partial breastfeeding through four months of age.


Mar 1, 2018 Issue
Written Action Plans for Self-Management of COPD Exacerbations
Written self-management plans, especially those that include guidance on smoking cessation, increase health-related quality of life in patients with COPD. They also decrease the need for respiratory-related hospital admissions among patients with high or low baseline risk.


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.


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