Evidence-based Healthcare最新文献

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High-quality nutrition counselling for hypercholesterolemia by public health nurses in rural areas does not affect total blood cholesterol 农村地区公共卫生护士对高胆固醇血症的高质量营养咨询对总血胆固醇没有影响

Evidence-based Healthcare

Pub Date : 2005-01-01 DOI: 10.1016/S1462-9410(03)00072-X

引用次数: 1

No association between mobile phone usage and development of acoustic neuroma 手机使用与听神经瘤的发展无关联

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.007

L. Hardell

引用次数: 2

Hormone replacement therapy is not safe for breast cancer survivors 激素替代疗法对乳腺癌幸存者来说并不安全

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.004

R. Vassilopoulou-sellin

引用次数: 0

Laparoscopic hysterectomy is not cost effective compared with vaginal hysterectomy 与阴道子宫切除术相比，腹腔镜子宫切除术不具有成本效益

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.014

B. Crawford

引用次数: 2

Link between diagnostic X-rays and cancer uncertain☆ 诊断x光与癌症之间的联系尚不明确

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.011

J. Cameron

引用次数: 4

Retaplase plus abciximab improves non-fatal outcomes, but not overall survival in people with diabetes and acute ST-segment elevation myocardial infarction Retaplase + abciximab可改善糖尿病合并急性st段抬高型心肌梗死患者的非致命性预后，但不能改善总生存率

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.001

Victor Serebruany MD, PhD (Commentary Author)

Question

In people with diabetes and ST-segment elevation myocardial infarction, is half-dose reteplase plus abciximab more effective than reteplase alone?

Study design

Secondary analysis of multicentre randomised controlled trial.

Main results

For mortality at 30 days or 1 year, there was no significant difference between groups (see Table 1). Reteplase plus abciximab significantly reduced the risk of reinfarction, or recurrent ischaemia or angina compared with reteplase alone.

Table 1 Clinical outcomes for people with diabetes and ST-segment myocardial infarction.
	Reteplase alone (n=1299)	Half-dose reteplase plus abciximab (n=1334)	P value
Death within 30 days	8.8%	8.2%	0.57
Death within 1 year	13.0%	12.4%	0.64
Reinfarction	4.3%	2.5%	0.01
Recurrent ischaemia/angina	14.9%	11.8%	0.01

Authors’ conclusions

Although treatment with reteplase plus abciximab did not provide a survival benefit for people with diabetes and ST-segment elevation myocardial infarction compared with reteplase alone, nonfatal outcomes including reinfarction and recurrent ischaemia were substantially reduced.

问题在糖尿病和ST段抬高型心肌梗死患者中，半剂量的雷普酶加阿昔单抗是否比单独使用雷普酶更有效？研究设计多中心随机对照试验的二次分析。主要结果对于30天或1年的死亡率，各组之间没有显著差异（见表1）。与单独使用瑞替普酶相比，瑞替普蛋白酶联合阿昔单抗显著降低了再梗死、复发性缺血或心绞痛的风险。表1糖尿病和ST段心肌梗死患者的临床结果。单独使用雷普酶（n=1299）半剂量雷普酶加阿昔单抗（n=1334）P值30天内死亡8.8%8.2%0.57 1年内死亡13.0%12.4%0.64再梗死4.3%2.5%0.01复发性缺血/血管痉挛14.9%11.8%0.01作者的结论尽管与单独使用瑞替普酶，包括再梗死和复发性缺血在内的非致命性结果显著降低。

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引用次数: 0

H. pylori eradication does not reduce gastric cancer incidence in a high-risk area of China 幽门螺杆菌根除并不能降低中国高风险地区胃癌的发病率

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.005

Bor-Shyang Sheu MD (Commentary Author), Xi-Zhang Lin MD (Commentary Author)

Question

Does treating H. Pylori reduce the incidence of gastric cancer?

Study

Randomised placebo-controlled trial.

Main results

At 7.5 years, incidence of gastric cancer was not significantly different between groups (treatment: 0.86%, n=7; placebo: 1.35%, n=11; p=0.33). In people without precancerous lesions at baseline, risk of gastric cancer was significantly lower for treatment compared with placebo (incidence of gastric cancer: treatment n=0; placebo n=6; p=0.02) but there was no difference among people with precancerous lesions (n=7 and 5, respectively). Smoking (hazard ratio [HR] 6.2, 95% CI 2.3 to 16.5) and older age (HR per 1 year 1.10, 95% CI 1.05 to 1.15) were independent predictors of gastric cancer risk.

Authors’ conclusions

Incidence of gastric cancer was similar between H. pylori eradication and placebo groups over 7.5 years of follow-up. However, it was significantly reduced in a subgroup of people without precancerous lesions at baseline.

问题治疗幽门螺杆菌能降低癌症的发病率吗？研究随机安慰剂对照试验。主要结果7.5年时，各组癌症发生率无显著差异（治疗组：0.86%，n=7；安慰剂组：1.35%，n=11；p=0.33），与安慰剂相比，治疗癌症的风险显著降低（癌症的发病率：治疗n=0；安慰剂n=6；p=0.02），但癌前病变患者之间没有差异（分别为n=7和5）。吸烟（危险比[HR]6.2，95%CI 2.3-16.5）和年龄较大（每1年HR 1.10，95%CI 1.05-1.15）是癌症风险的独立预测因素。作者的结论在7.5年的随访中，根除幽门螺杆菌组和安慰剂组的癌症发病率相似。然而，在基线时没有癌前病变的亚组中，它显著降低。

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引用次数: 2

Unscheduled care for people with asthma in a multi-ethnic area is reduced following educational outreach programme by specialist nurses☆ 在一个多民族地区，通过专科护士的教育推广方案，减少了对哮喘患者的计划外护理

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/J.EHBC.2004.05.017

A. Kamps

引用次数: 5

No association between mobile phone usage and development of acoustic neuroma 手机使用与听神经瘤的发展无关联

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.007

Lennart Hardell MD, PhD (Commentary Author)

Question

Is the incidence of acoustic neuroma associated with mobile phone usage?

Study design

Population-based case-control study.

Main results

Risk of acoustic neuroma was not statistically higher among people regularly using mobile phones compared with those who never or rarely using one (OR 0.90, 95% CI 0.51 to 1.57). No increased risk was associated with the length of time since beginning regular use of mobile phones, total duration or number of calls (see Table 1). In people with acoustic neuroma, mean tumour size was bigger in regular mobile phone users (1.66 cm³) than non-users (1.39 cm³) (Wilcoxon, p=0.03) but the increased risk of developing a large tumour (⩾1.51 cm³) was not statistically significant (OR 1.87, 95% CI 0.75 to 4.64).

Authors’ conclusions

Mobile phone usage is not positively associated with the development of acoustic neuroma, regardless of the estimated total duration or number of calls, or the length of time since regular use began.

Table 1 Odds of developing acoustic neuroma according to mobile phone usage
Time since beginning of regular usage	OR	95% CI
Never/rarely used/<1 year	1.00
1 to 4 years	0.86	0.45 to 1.62
⩾5 years	0.68	0.32 to 1.44
5 to 9 years	0.86	0.39 to 1.93
⩾10 years	0.22	0.04 to 1.11

Life time cumulative number of calls
Never/rarely used	1.00
⩽2975	0.99	0.53 to 1.83
2975 to 11 550	0.79	0.32 to 1.92
>11 550	0.72	0.28 to 1.87

Life time cumulative hours of use
Never/rarely used	1.00
⩽167.5	0.93	0.49 to 1.74
>167.5 to 654	1.01	0.43 to 2.38
>1654	0.66	0.25 to 1.74

问题听神经瘤的发生率与使用手机有关吗？研究设计基于人群的病例对照研究。主要结果经常使用手机的人患听神经瘤的风险在统计学上并不比从不使用或很少使用手机的人群高（or 0.90，95%CI 0.51-1.57）。风险的增加与开始经常使用手机后的时间长度、总通话时间或通话次数无关（见表1）。在听神经瘤患者中，经常使用手机的患者的平均肿瘤大小（1.66 cm3）比不使用手机的人（1.39 cm3）大（Wilcoxon，p=0.03），但患大肿瘤的风险增加（1.51 cm3）在统计学上并不显著（OR 1.87，95%CI 0.75至4.64），而不管估计的总持续时间或呼叫次数或自开始正常使用以来的时间长度。表1根据手机使用情况发展为听神经瘤的几率自开始定期使用以来的时间OR95%CIN曾经/很少使用/<；1年1.001至4年0.860.45至1.62⩾5年0.680.32至1.445至9年0.860.39至1.93 10878 10年0.220.04至1.11一生累计通话次数从未/很少使用1.00⩽29750.990.53至1.832975至11 5500.790.32至1.92>；11 5500.720.28至1.87使用寿命累计小时从不/很少使用1.00⩽167.50.930.49至1.74>；167.5至6541.010.43至2.38>；16540.660.25至1.74

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引用次数: 2

Hormone replacement therapy is not safe for breast cancer survivors 激素替代疗法对乳腺癌幸存者来说并不安全

Evidence-based Healthcare

Pub Date : 2004-08-01 DOI: 10.1016/j.ehbc.2004.05.004

Rena Vassilopoulou-Sellin MD (Commentary Author)

Question

Is hormone replacement therapy safe for women with previous breast cancer?

Study design

Randomised controlled trial (interim analysis).

Main results

In 345 women surviving breast cancer, there were more new breast cancer events in women taking HRT for menopausal symptoms compared with women receiving symptomatic treatment without hormones at a median of 2 years follow-up (absolute risk for new breast cancer: 26/174 [14%] with HRT vs 8/171 [5%] with no HRT; relative hazard 3.5, 95% CI 1.5 to 8.1).

Authors’ conclusions

In women surving breast cancer, those who received HRT for menopausal symptoms were at a higher risk of developing new breast cancers compared with those who received symptomatic treatment without hormones. These findings led to the termination of the trial.

问题：激素替代疗法对既往患有癌症的女性安全吗？研究设计随机对照试验（中期分析）。主要结果在345例癌症患者中，在中位2年的随访中，因更年期症状而服用激素替代疗法的女性与未服用激素的有症状治疗的女性相比，有更多的新乳腺癌症事件（新乳腺癌症的绝对风险：使用激素替代疗法时为26/174[14%]，而未使用激素替代治疗时为8/171[5]；相对风险3.5，95%CI 1.5至8.1），那些因更年期症状而接受激素替代疗法的人与那些接受无激素症状治疗的人相比，患新乳腺癌的风险更高。这些发现导致审判终止。

引用次数: 0

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