AFP DEPARTMENT COLLECTION

Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Nov 1, 2019 Issue
Renin-Angiotensin System Inhibitors vs. Other Antihypertensive Drug Classes for Hypertension
RAS inhibitors, which include angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, and renin inhibitors, should not be used as first-line agents.


Nov 1, 2019 Issue
Oral H1 Antihistamines as Add-on Therapy to Topical Treatment for Eczema
In children with eczema, there is no evidence to support the addition of oral H1 antihistamines to standard treatment regimens. In adults, the use of fexofenadine (Allegra), 120 mg per day, improves patient-assessed eczema symptoms compared with placebo (number needed to treat = 11; 95% CI, 5.5 to 255).


Oct 1, 2019 Issue
Effectiveness and Safety of Factor Xa Inhibitors in Patients with Atrial Fibrillation
Treatment of AFib with a factor Xa inhibitor results in a decrease in the combined end point of stroke and embolic events (odds ratio [OR] = 0.89; 95% CI, 0.82 to 0.97), as well as a decrease in intracranial hemorrhage (OR = 0.50; 95% CI, 0.42 to 0.59) and all-cause mortality (OR = 0.89; 95% CI, 0.83 to 0.95) compared with warfarin (Coumadin) therapy.


Oct 1, 2019 Issue
Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy
Compared with placebo, antihypertensive drug therapy for mild to moderate hypertension (defined by the authors as a blood pressure of 140 to 169 mm Hg systolic or 90 to 109 mm Hg diastolic) caused by chronic hypertension, gestational hypertension, or preeclampsia during pregnancy does not affect any pregnancy outcomes.


Sep 1, 2019 Issue
Treatment of Threatened Miscarriage with Progestogens
Progestogens reduce the risk of miscarriage when compared with placebo in patients with threatened miscarriage (number needed to treat [NNT] = 10.) Use of progestogens poses no significant risks to mother or baby.


Sep 1, 2019 Issue
Use of Amphetamines for Attention Deficit/Hyperactivity Disorder in Adults
Amphetamines provide a clinician-rated 30% or greater reduction in ADHD symptoms when compared with placebo (number needed to treat = 5).


Aug 1, 2019 Issue
Vaccines for Preventing Influenza in Healthy Children, Healthy Adults, and Older Adults
Influenza vaccination reduces rates of laboratory-confirmed influenza and symptomatic influenza-like illness in healthy children, healthy adults, and older adults. There is no consistent evidence that influenza vaccination reduces school absenteeism in children, parental absenteeism from work, or adult hospitalizations, nor is there conclusive evidence that influenza vaccination decreases mortality.


Jul 1, 2019 Issue
Medication Management for Chronic Heart Failure with Preserved Ejection Fraction
Mineralocorticoid receptor antagonists reduce hospitalizations for patients with HFpEF. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have not been shown to change the morbidity or mortality in patients with HFpEF.


Jul 1, 2019 Issue
Noninvasive Diagnostic Tests for Helicobacter pylori Infection
When compared with serology or stool antigen tests, the urea breath test has the highest diagnostic accuracy to identify H. pylori infection in patients without a history of gastrectomy or recent use of antibiotics or proton pump inhibitors.


Jun 1, 2019 Issue
Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men
In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.


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