Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Oct 1, 2018 Issue
Interventions for Increasing Fruit and Vegetable Consumption in Children Five Years and Younger
Child feeding interventions are effective in the short term (i.e., less than 12 months) for increasing a child's intake of fruits and vegetables, but only by less than 5% of the recommended daily allowance. Conversely, parental nutrition education and multicomponent interventions, such as combining preschool policy with parental education, are not effective.

Sep 1, 2018 Issue
Feed Thickener for Newborn Infants with Gastroesophageal Reflux
Feed thickeners decrease the number of reflux episodes in full-term formula-fed infants. Additionally, full-term formula-fed infants with GER who are given thickeners are more than twice as likely to be asymptomatic compared with infants not receiving thickeners at one to eight weeks of follow-up.

Sep 1, 2018 Issue
Blood Pressure Targets for Patients with Hypertension and Cardiovascular Disease
Achieving a target BP of 135/85 mm Hg or less does not decrease the risk of total cardiovascular events vs. treating to a target of 140 to 160/90 to 100 mm Hg. Further, treating to the lower BP target does not improve total mortality, cardiovascular mortality, or serious adverse effects.

Aug 1, 2018 Issue
Interventions for Treatment of Overweight and Obese Children
Interventions that include combinations of diet, physical activity, and behavior changes may reduce weight, body mass index (BMI), and BMI z-score (equivalent to BMI-for-age percentile) in overweight and obese children six to 11 years of age.

Aug 1, 2018 Issue
The Role of Proton Pump Inhibitor Therapy in Patients with Functional Dyspepsia
There is moderate-quality evidence that PPIs are more effective than placebo at relieving overall symptoms in patients with functional dyspepsia (number needed to treat [NNT] = 11). Low-quality evidence suggests a small benefit of PPI therapy compared with prokinetics, and little to no benefit of PPI therapy vs. histamine H2 antagonists.

Jul 1, 2018 Issue
Procalcitonin to Guide Antibiotic Therapy in Acute Respiratory Infections
Procalcitonin-guided antibiotic therapy, when compared with routine treatments, results in decreased mortality in patients with acute respiratory infections (absolute risk reduction [ARR] = 1.4%; number needed to treat [NNT] = 71).

Jul 1, 2018 Issue
Individual Behavioral Counseling for Smoking Cessation
Individual behavioral counseling conducted by a trained therapist provides some benefit when compared with brief counseling and support; however, this benefit is less pronounced in the context of pharmacotherapy.

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.

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.

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).

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