Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

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.

Sep 1, 2017 Issue
Pregabalin for Fibromyalgia Pain in Adults
There is high-quality evidence that pregabalin in daily dosages of 300 mg, 450 mg, and 600 mg reduces pain associated with fibromyalgia. The most effective dosage seems to be 450 mg daily; this dosage is more effective than placebo at reducing pain by at least 50% (number needed to treat [NNT] = 9.7).

Aug 1, 2017 Issue
Antiplatelet vs. Anticoagulation Therapy for Patients with Heart Failure in Sinus Rhythm
Heart failure increases the risk of thrombotic complications, but use of warfarin does not lower all-cause mortality more than aspirin in patients with heart failure with reduced ejection fraction in sinus rhythm.

Aug 1, 2017 Issue
Effects of Yoga in Patients with Asthma
Regular yoga improves quality of life as measured on the Asthma Quality of Life Questionnaire (mean difference = 0.57 units on a seven-point scale; 95% confidence interval [CI], 0.37 to 0.77); improves asthma symptoms (standardized mean difference = 0.37; 95% CI, 0.09 to 0.65); and reduces medication use (relative risk [RR] = 5.35; 95% CI, 1.29 to 22.11).

Jul 1, 2017 Issue
Acupuncture for Migraine Prevention
There is moderate-quality evidence that whole-body acupuncture is effective for migraine prevention. Compared with usual care, acupuncture is more effective at reducing headache frequency by at least 50% (number needed to treat [NNT] = 4).

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