Surendra K. Sharma, Tamilarasu Kadhiravan, Prathap Tharyan
Cochrane Review: Rifamycins (rifampicin, rifabutin, and rifapentine) compared to isoniazid for preventing tuberculosis in HIV-negative people at risk of active TB Sharma SK, Sharma A, Kadhiravan T, Tharyan P. Rifamycins (rifampicin, rifabutin and rifapentine) compared to isoniazid for preventing tuberculosis in HIV-negative people at risk of active TB. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD007545. DOI: 10.1002/14651858.CD007545.pub2.
This companion piece to the review, “Rifamycins (rifampicin, rifabutin, and rifapentine) compared to isoniazid for preventing tuberculosis in HIV-negative people at risk of active TB,” contains the following pieces:
Cochrane综述:利福霉素(利福平、利福布汀和利福喷丁)与异烟肼在hiv阴性、有活动性结核病风险人群中预防结核病的效果比较Sharma SK, Sharma A, Kadhiravan T, Tharyan P.利福霉素(利福平、利福布汀和利福喷丁)与异烟肼在有活动性结核病风险的hiv阴性人群中预防结核病的效果比较。Cochrane Database of Systematic Reviews 2013，第7期。艺术。不。: CD007545。cd007545.pub2 DOI: 10.1002/14651858.。这篇综述的同伴文章“利福霉素(利福平、利福布汀和利福喷丁)与异烟肼在预防活动性结核病风险的hiv阴性人群中的结核病中的作用”包含以下内容:
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Jirong Yue, Bi Rong Dong, Ming Yang, Xiaomei Chen, Taixiang Wu, Guan J Liu
Background
The morbidity and treatment costs associated with skin and soft tissue infections (SSTIs) are high. Linezolid and vancomycin are antibiotics that are commonly used in treating skin and soft-tissue infections, specifically those infections due to methicillin-resistant Staphylococcus aureus (MRSA).
Objectives
To compare the effects and safety of linezolid and vancomycin for treating people with SSTIs.
Search methods
In May 2013 we conducted searches of the following databases: Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We also contacted manufacturers for details of unpublished and ongoing trials. We scrutinised citations within all obtained trials and major review articles to identify any additional trials.
Selection criteria
We included all randomised controlled trials (RCTs) comparing linezolid with vancomycin in the treatment of SSTIs.
Data collection and analysis
Two review authors independently selected trials, assessed risk of bias and extracted data. The primary outcomes were clinical cure, microbiological cure, and SSTI-related and treatment-related mortality. We performed subgroup analyses according to age, and whether the infection was due to MRSA.
Main results
We included nine RCTs (3144 participants). Linezolid was associated with a significantly better clinical (RR 1.09, 95% CI 1.03 to 1.16) and microbiological cure rate in adults (RR 1.08, 95% CI 1.01 to 1.16). For those infections due to MRSA, linezolid was significantly more effective than vancomycin in clinical (RR 1.09, 95% CI 1.03 to 1.17) and microbiological cure rates (RR 1.17, 95% CI 1.04 to 1.32). No RCT reported SSTI-related and treatment-related mortality. There was no significant difference in all-cause mortality between linezolid and vancomycin (RR 1.44, 95% CI 0.75 to 2.80). There were fewer incidents of red man syndrome (RR 0.04, 95% CI 0.01 to 0.29), pruritus (RR 0.36, 95% CI 0.17 to 0.75) and rash (RR 0.27, 95% CI 0.12 to 0.58) in the linezolid group compared with vancomycin, however, more people reported thrombocytopenia (RR 13.06, 95% CI 1.72 to 99.22), and nausea
背景皮肤和软组织感染(SSTIs)的发病率和治疗费用很高。利奈唑胺和万古霉素是通常用于治疗皮肤和软组织感染的抗生素，特别是那些由耐甲氧西林金黄色葡萄球菌(MRSA)引起的感染。目的比较利奈唑胺与万古霉素治疗性传播感染的疗效和安全性。检索方法2013年5月，我们对以下数据库进行了检索:Cochrane Wounds Group specialized Register;Cochrane中央对照试验登记(Central) (Cochrane图书馆);奥维德MEDLINE;Ovid MEDLINE(进程中&其他非索引引文);奥维德EMBASE;EBSCO CINAHL。我们还联系了制造商，了解未发表和正在进行的试验的细节。我们仔细检查了所有获得的试验和主要综述文章的引用，以确定任何额外的试验。我们纳入了比较利奈唑胺和万古霉素治疗ssti的所有随机对照试验(RCTs)。数据收集和分析两位综述作者独立选择试验，评估偏倚风险并提取数据。主要结局是临床治愈、微生物治愈、ssti相关死亡率和治疗相关死亡率。我们根据年龄和感染是否由MRSA引起进行了亚组分析。我们纳入了9项rct(3144名受试者)。利奈唑胺与较好的临床(RR 1.09, 95% CI 1.03 ~ 1.16)和成人微生物治愈率(RR 1.08, 95% CI 1.01 ~ 1.16)相关。对于MRSA引起的感染，利奈唑胺在临床(RR 1.09, 95% CI 1.03 ~ 1.17)和微生物治愈率(RR 1.17, 95% CI 1.04 ~ 1.32)上明显优于万古霉素。没有随机对照试验报告性传播感染相关和治疗相关的死亡率。利奈唑胺和万古霉素的全因死亡率无显著差异(RR 1.44, 95% CI 0.75 ~ 2.80)。与万古霉素相比，利奈唑胺组红人综合征(RR 0.04, 95% CI 0.01至0.29)、瘙痒(RR 0.36, 95% CI 0.17至0.75)和皮疹(RR 0.27, 95% CI 0.12至0.58)的发生率较低，然而，利奈唑胺组报告血小板减少(RR 13.06, 95% CI 1.72至99.22)和恶心(RR 2.45, 95% CI 1.52至3.94)的发生率较高。从现有的数据来看，利奈唑胺组的住院时间似乎比万古霉素组短。每日门诊治疗费用口服利奈唑胺低于静脉注射万古霉素。虽然每天使用利奈唑胺的住院治疗费用高于使用万古霉素的住院治疗费用，但利奈唑胺的中位住院时间比使用万古霉素的住院时间短3天。因此，利奈唑胺治疗每位患者的总医院费用低于万古霉素治疗。作者的结论:利奈唑胺似乎比万古霉素更有效地治疗ssti患者，包括由MRSA引起的ssti。现有的证据有很高的偏倚风险，而且是基于生产利奈唑胺的制药公司支持的研究。需要进一步精心设计、独立资助的随机对照试验来证实现有证据。治疗皮肤和软组织感染的抗生素药物皮肤和软组织感染如脓疱疮、脓肿、溃疡和手术部位感染是常见的皮肤感染。对于涉及深层组织的严重皮肤和软组织感染，死亡率和治疗费用很高。利奈唑胺和万古霉素是有效治疗皮肤和软组织感染的抗生素，特别是由对某些抗生素产生耐药性的细菌引起的感染。本综述确定了9项随机对照试验，共3144名受试者，比较了利奈唑胺治疗和万古霉素治疗皮肤和软组织感染的效果。利奈唑胺被发现比万古霉素更有效地治疗这些感染。利奈唑胺组皮肤并发症较少。两组之间报告的死亡人数没有差异，用利奈唑胺治疗的患者比用万古霉素治疗的患者住院时间短。 门诊每日治疗费用口服利奈唑胺低于静脉注射万古霉素，但住院治疗费用利奈唑胺高于万古霉素。未来需要设计良好的试验来证实这些结果，因为得出这些结论的试验方法学质量很差，有很高的偏倚风险，而且是由制造利奈唑胺的制药公司资助的。
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Cochrane Review: Linezolid versus vancomycin for skin and soft tissue infections. Yue J, Dong BR, Yang M, Chen X, Wu T, Liu GJ. Linezolid versus vancomycin for skin and soft tissue infections. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD008056. DOI: 10.1002/14651858.CD008056.pub2.
This companion piece to the review, “Linezolid versus vancomycin for skin and soft tissue infections,” contains the following pieces:
Cochrane综述:利奈唑胺与万古霉素治疗皮肤和软组织感染。岳军，董瑞麟，杨敏，陈旭，吴涛，刘国军。利奈唑胺与万古霉素治疗皮肤和软组织感染。Cochrane Database of Systematic Reviews 2013，第7期。艺术。不。: CD008056。cd008056.pub2 DOI: 10.1002/14651858.。这篇综述的配套文章“利奈唑胺与万古霉素治疗皮肤和软组织感染”包含以下几个部分:
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Eco-paediatrics is an occasional feature in Evidence-Based Child Health: A Cochrane Review Journal. Our goal is to contribute to the worldwide discussion on reducing waste in health care. In each instalment, we will select a recent Cochrane review highlighting a practice, still in use, which the available evidence tells us should be discontinued.
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Vittorio Demicheli, Alessandro Rivetti, Maria Grazia Debalini, Carlo Di Pietrantonj
Background
Mumps, measles and rubella (MMR) are serious diseases that can lead to potentially fatal illness, disability and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness.
Objectives
To assess the effectiveness and adverse effects associated with the MMR vaccine in children up to 15 years of age.
Search methods
For this update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, PubMed (July 2004 to May week 2, 2011) and Embase.com (July 2004 to May 2011).
Selection criteria
We used comparative prospective or retrospective trials assessing the effects of the MMR vaccine compared to placebo, do nothing or a combination of measles, mumps and rubella antigens on healthy individuals up to 15 years of age.
Data collection and analysis
Two review authors independently extracted data and assessed methodological quality of the included studies. One review author arbitrated in case of disagreement.
Main results
We included five randomised controlled trials (RCTs), one controlled clinical trial (CCT), 27 cohort studies, 17 case-control studies, five time-series trials, one case cross-over trial, two ecological studies, six self controlled case series studies involving in all about 14,700,000 children and assessing effectiveness and safety of MMR vaccine. Based on the available evidence, one MMR vaccine dose is at least 95% effective in preventing clinical measles and 92% effective in preventing secondary cases among household contacts.
Effectiveness of at least one dose of MMR in preventing clinical mumps in children is estimated to be between 69% and 81% for the vaccine prepared with Jeryl Lynn mumps strain and between 70% and 75% for the vaccine containing the Urabe strain. Vaccination with MMR containing the Urabe strain has demonstrated to be 73% effective in preventing secondary mumps cases. Effectiveness of Jeryl Lynn containing MMR in preventing laboratory-confirmed mumps cases in children and adolescents was estimat
背景腮腺炎、麻疹和风疹(MMR)是可导致潜在致命疾病、残疾和死亡的严重疾病。然而，尽管三价MMR疫苗的使用几乎是普遍的，其有效性也得到公认，但在一些国家，公众对其安全性以及由此导致的疫苗接种覆盖率下降的争论仍在继续。目的评估MMR疫苗在15岁以下儿童中的有效性和不良反应。在这次更新中，我们检索了Cochrane中央对照试验登记册(Central) (Cochrane图书馆2011年第2期)，其中包括Cochrane急性呼吸道感染组专门登记册、PubMed(2004年7月至2011年5月第2周)和Embase.com(2004年7月至2011年5月)。选择标准:我们采用前瞻性或回顾性比较试验，评估MMR疫苗与安慰剂、无作用疫苗或麻疹、腮腺炎和风疹抗原组合疫苗对15岁以下健康个体的影响。资料收集和分析两位综述作者独立提取资料并评估纳入研究的方法学质量。如果意见不一致，由一位评审作者进行仲裁。我们纳入了5项随机对照试验(RCTs)、1项对照临床试验(CCT)、27项队列研究、17项病例对照研究、5项时间序列试验、1项病例交叉试验、2项生态学研究、6项自我对照病例系列研究，共涉及约1470万名儿童，评估了MMR疫苗的有效性和安全性。根据现有证据，一剂MMR疫苗在预防临床麻疹方面至少95%有效，在预防家庭接触者中的继发性病例方面至少92%有效。据估计，用Jeryl Lynn腮腺炎株制备的疫苗至少一剂MMR在预防儿童临床腮腺炎方面的有效性在69%至81%之间，而含有Urabe腮腺炎株的疫苗在70%至75%之间。经证明，接种含有Urabe毒株的MMR疫苗在预防继发性腮腺炎病例方面的有效性为73%。据估计，含有MMR疫苗的Jeryl Lynn在预防经实验室确认的儿童和青少年流行性腮腺炎病例方面，一剂疫苗的有效性为64%至66%，两剂疫苗的有效性为83%至88%。我们没有发现任何评估MMR在预防风疹方面有效性的研究。在接种含有urabe的MMR疫苗后的第三周内观察到与无菌性脑膜炎相关的最高风险(风险比(RR) 14.28;95%可信区间(CI)为7.93 ~ 25.71)和第三组(RR 22.5;95% CI 11.8 ~ 42.9)或第五(RR 15.6;使用列宁格勒-萨格勒布菌株制备的疫苗免疫后10.3至24.2周的95% CI。与前两周发热性惊厥和MMR暴露相关的显著风险(RR 1.10;在一项涉及537,171名年龄在3个月至5岁之间的儿童的大型人群队列研究中评估了95% CI 1.05至1.15)。在12至23个月的儿童中也观察到热性癫痫发作的风险增加(相对发病率(RI) 4.09;95% CI 3.1至5.33)和12至35个月的儿童(RI 5.68;(95%可信区间2.31至13.97)在接触MMR疫苗后6至11天内。一项病例对照研究评估了12至23个月儿童接种MMR疫苗后6周内血小板减少性紫癜的风险增加(RR 6.3;95% CI 1.3 - 30.1)和一个小型自我控制病例系列(发病率比(IRR) 5.38;95% CI 2.72 - 10.62)。另一项病例对照研究也评估了MMR暴露后6周内血小板减少性紫癜的风险增加，该研究涉及2311名1个月至18岁的儿童和青少年(优势比(OR) 2.4;95% CI 1.2 - 4.7)。接触MMR疫苗不太可能与自闭症、哮喘、白血病、花粉热、1型糖尿病、步态障碍、克罗恩病、脱髓鞘疾病、细菌或病毒感染有关。在MMR疫苗上市前和上市后的研究中，安全性结果的设计和报告在很大程度上是不充分的。接种MMR疫苗后出现不良事件的证据不能与其在预防目标疾病方面的作用分开。
{"title":"Vaccines for measles, mumps and rubella in children","authors":"Vittorio Demicheli, Alessandro Rivetti, Maria Grazia Debalini, Carlo Di Pietrantonj","doi":"10.1002/ebch.1948","DOIUrl":"https://doi.org/10.1002/ebch.1948","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mumps, measles and rubella (MMR) are serious diseases that can lead to potentially fatal illness, disability and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the effectiveness and adverse effects associated with the MMR vaccine in children up to 15 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search methods</h3>\u0000 \u0000 <p>For this update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (<i>The Cochrane Library</i> 2011, Issue 2), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, PubMed (July 2004 to May week 2, 2011) and Embase.com (July 2004 to May 2011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>We used comparative prospective or retrospective trials assessing the effects of the MMR vaccine compared to placebo, do nothing or a combination of measles, mumps and rubella antigens on healthy individuals up to 15 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Two review authors independently extracted data and assessed methodological quality of the included studies. One review author arbitrated in case of disagreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>We included five randomised controlled trials (RCTs), one controlled clinical trial (CCT), 27 cohort studies, 17 case-control studies, five time-series trials, one case cross-over trial, two ecological studies, six self controlled case series studies involving in all about 14,700,000 children and assessing effectiveness and safety of MMR vaccine. Based on the available evidence, one MMR vaccine dose is at least 95% effective in preventing clinical measles and 92% effective in preventing secondary cases among household contacts.</p>\u0000 \u0000 <p>Effectiveness of at least one dose of MMR in preventing clinical mumps in children is estimated to be between 69% and 81% for the vaccine prepared with Jeryl Lynn mumps strain and between 70% and 75% for the vaccine containing the Urabe strain. Vaccination with MMR containing the Urabe strain has demonstrated to be 73% effective in preventing secondary mumps cases. Effectiveness of Jeryl Lynn containing MMR in preventing laboratory-confirmed mumps cases in children and adolescents was estimat","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137946390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An issue full of primarily preventative strategies","authors":"Joan Robinson","doi":"10.1002/ebch.1946","DOIUrl":"10.1002/ebch.1946","url":null,"abstract":"","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76323708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Harrold, S. Ali, M. Oleszczuk, T. Lacaze-Masmonteil, L. Hartling
Background
Bronchopulmonary dysplasia (BPD) is an important complication associated with considerable morbidity in preterm infants. Corticosteroids in various regimens have been tried out to prevent BPD.
Objective
To examine the evidence from Cochrane systematic reviews regarding the effectiveness and associated complications of corticosteroids used to prevent BPD in preterm infants.
Methods
The Cochrane Database of Systematic Reviews was searched to identify reviews of corticosteroids for BPD in preterm infants. Data were extracted by one investigator, and checked by a second investigator for accuracy. Results are presented as risk ratios (RR) with 95% confidence intervals (CI). We considered <8 days as early and >7 days as late administration.
Main results
Six reviews (67 trials and 6535 patients) were included and covered three main comparisons: inhaled corticosteroids versus placebo, inhaled versus systemic corticosteroids and systemic corticosteroids versus placebo. Systemic corticosteroids compared with placebo significantly reduced the incidence of BPD (early: RR 0.79, 95% CI 0.71–0.88; late: RR 0.72, 95% CI 0.63–0.82), and BPD or mortality (early: RR 0.89, 95% CI 0.84–0.95; late: RR 0.72, 95% CI 0.63–0.82) at 36 weeks post-menstrual age. Similar results were observed for these outcomes assessed at 28 days of life at which time there was additionally a reduction in mortality (late: RR 0.49, 95% CI 0.28–0.85). There was a higher incidence of cerebral palsy associated with systemic corticosteroids compared with placebo when initiated early (RR 1.45, 95% CI 1.06–1.98). No differences in neurodisability based on Bayley Mental or Psychomotor Developmental Index scores were observed for inhaled or systemic corticosteroids compared with placebo. Hypertension was significantly increased in association with systemic corticosteroids versus placebo (early: RR 1.85, 95% CI 1.55–2.22; late: RR 2.66, 95% CI 1.58–4.49) as were gastrointestinal (GI) perforations when treatment was initiated early (RR 1.81, 95% CI 1.33–2.48).
Author's Conclusion
Systemic corticosteroids decrease BPD and early mortality in premature infants but have a risk of complications, particularly when initiated in the first week of life. Owing to the wide range of dosing protocols, timing of initiation, doses and duration of therapy in the included reviews, it is difficult to determine, based on the evid
背景:支气管肺发育不良(BPD)是早产儿发病率较高的重要并发症。已经尝试了各种治疗方案中的皮质类固醇来预防BPD。目的从Cochrane系统评价中探讨皮质类固醇预防早产儿BPD的有效性及相关并发症。方法检索Cochrane系统评价数据库，以确定皮质类固醇治疗早产儿BPD的评价。数据由一名调查员提取，并由另一名调查员检查其准确性。结果以95%置信区间(CI)的风险比(RR)表示。我们认为早给药8天，晚给药7天。主要结果纳入6篇综述(67项试验，6535例患者)，并涵盖3个主要比较:吸入糖皮质激素与安慰剂、吸入糖皮质激素与全身糖皮质激素、全身糖皮质激素与安慰剂。与安慰剂相比，全身性皮质类固醇显著降低BPD的发生率(早期:RR 0.79, 95% CI 0.71-0.88;晚期:RR 0.72, 95% CI 0.63-0.82)， BPD或死亡率(早期:RR 0.89, 95% CI 0.84-0.95;晚期:RR 0.72, 95% CI 0.63-0.82)。在生命第28天评估这些结果时观察到类似的结果，此时死亡率也有所降低(晚期:RR 0.49, 95% CI 0.28-0.85)。早期开始使用全体性皮质类固醇与安慰剂相比，脑瘫的发生率更高(RR 1.45, 95% CI 1.06-1.98)。根据贝利精神或精神运动发育指数评分，吸入或全身皮质类固醇与安慰剂相比，在神经残疾方面没有观察到差异。与安慰剂相比，全体性皮质类固醇组高血压显著增加(早期:RR 1.85, 95% CI 1.55-2.22;晚期:RR 2.66, 95% CI 1.58-4.49)，早期开始治疗的胃肠道穿孔也是如此(RR 1.81, 95% CI 1.33-2.48)。作者的结论:全身性皮质类固醇降低了早产儿的BPD和早期死亡率，但有并发症的风险，特别是在出生后第一周开始使用。由于纳入综述的给药方案、起始时间、剂量和治疗持续时间范围广泛，因此很难根据本综述所审查的证据确定一种既安全又有效的方案。进一步的研究应侧重于确定出生后第一周后皮质类固醇给药的最有效剂量和时间，以最大限度地降低BPD和死亡率，同时避免短期和长期危害。
{"title":"Corticosteroids for the prevention of bronchopulmonary dysplasia in preterm infants: an overview of Cochrane reviews","authors":"J. Harrold, S. Ali, M. Oleszczuk, T. Lacaze-Masmonteil, L. Hartling","doi":"10.1002/ebch.1955","DOIUrl":"10.1002/ebch.1955","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bronchopulmonary dysplasia (BPD) is an important complication associated with considerable morbidity in preterm infants. Corticosteroids in various regimens have been tried out to prevent BPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the evidence from Cochrane systematic reviews regarding the effectiveness and associated complications of corticosteroids used to prevent BPD\t in preterm infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Cochrane Database of Systematic Reviews was searched to identify reviews of corticosteroids for BPD in preterm infants. Data were extracted by one investigator, and checked by a second investigator for accuracy. Results are presented as risk ratios (RR) with 95% confidence intervals (CI). We considered <8 days as early and >7 days as late administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>Six reviews (67 trials and 6535 patients) were included and covered three main comparisons: inhaled corticosteroids versus placebo, inhaled versus systemic corticosteroids and systemic corticosteroids versus placebo. Systemic corticosteroids compared with placebo significantly reduced the incidence of BPD (early: RR 0.79, 95% CI 0.71–0.88; late: RR 0.72, 95% CI 0.63–0.82), and BPD or mortality (early: RR 0.89, 95% CI 0.84–0.95; late: RR 0.72, 95% CI 0.63–0.82) at 36 weeks post-menstrual age. Similar results were observed for these outcomes assessed at 28 days of life at which time there was additionally a reduction in mortality (late: RR 0.49, 95% CI 0.28–0.85). There was a higher incidence of cerebral palsy associated with systemic corticosteroids compared with placebo when initiated early (RR 1.45, 95% CI 1.06–1.98). No differences in neurodisability based on Bayley Mental or Psychomotor Developmental Index scores were observed for inhaled or systemic corticosteroids compared with placebo. Hypertension was significantly increased in association with systemic corticosteroids versus placebo (early: RR 1.85, 95% CI 1.55–2.22; late: RR 2.66, 95% CI 1.58–4.49) as were gastrointestinal (GI) perforations when treatment was initiated early (RR 1.81, 95% CI 1.33–2.48).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Author's Conclusion</h3>\u0000 \u0000 <p>Systemic corticosteroids decrease BPD and early mortality in premature infants but have a risk of complications, particularly when initiated in the first week of life. Owing to the wide range of dosing protocols, timing of initiation, doses and duration of therapy in the included reviews, it is difficult to determine, based on the evid","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85817758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cochrane Review: Parent-mediated early intervention for young children with autism spectrum disorders (ASD) Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009774. DOI: 10.1002/14651858.CD009774.pub2
This companion piece, “Parent-mediated early intervention for young children with autism spectrum disorders (ASD),” contains the following pieces:
刘建平，刘建平，刘建平，等。儿童自闭症谱系障碍早期干预的研究进展。Cochrane Database of Systematic Reviews 2013，第4期。艺术。不。: CD009774。cd009774 DOI: 10.1002/14651858.。这篇题为“父母对患有自闭症谱系障碍(ASD)的幼儿进行早期干预”的文章包含以下内容:
{"title":"Cochrane in context: Parent-mediated early intervention for young children with autism spectrum disorders (ASD)","authors":"Helen McConachie, Inalegwu Oono","doi":"10.1002/ebch.1954","DOIUrl":"10.1002/ebch.1954","url":null,"abstract":"<p><b>Cochrane Review: Parent-mediated early intervention for young children with autism spectrum disorders (ASD)</b> Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009774. DOI: 10.1002/14651858.CD009774.pub2</p><p>This companion piece, “Parent-mediated early intervention for young children with autism spectrum disorders (ASD),” contains the following pieces:\u0000\u0000 </p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87639381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The commentaries in this section refer to the review, Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009774. DOI: 10.1002/14651858.CD009774.pub2.
Editor's note: Parents of children with autism often have a complicated life. In some cases, because of their child's behavior, they cannot take them to a restaurant or to a movie, let alone on a vacation. Finding child-care may be impossible. Some children with autism appear to be unhappy much of the time. Most parents would fly to the moon if that would make their child better, but it is our responsibility as clinicians to only assign parents tasks that are likely to benefit their child. In their commentaries, Professors Jacqueline Roberts and Cheryl Dissanayake provide their opinions on the fine art of balancing what we ask parents of autistic children to do.
{"title":"Focus on implementation: Parent-mediated early intervention for young children with autism spectrum disorders (ASD)","authors":"Jacqueline Roberts, Cheryl Dissanayake","doi":"10.1002/ebch.1953","DOIUrl":"10.1002/ebch.1953","url":null,"abstract":"<p><b>The commentaries in this section refer to the review,</b> Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009774. DOI: 10.1002/14651858.CD009774.pub2.</p><p><i>Editor's note: Parents of children with autism often have a complicated life. In some cases, because of their child's behavior, they cannot take them to a restaurant or to a movie, let alone on a vacation. Finding child-care may be impossible. Some children with autism appear to be unhappy much of the time. Most parents would fly to the moon if that would make their child better, but it is our responsibility as clinicians to only assign parents tasks that are likely to benefit their child. In their commentaries, Professors Jacqueline Roberts and Cheryl Dissanayake provide their opinions on the fine art of balancing what we ask parents of autistic children to do</i>.</p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84407281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cochrane Review: Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, Barsic B. Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD006602. DOI: 10.1002/14651858.CD006602.pub4
This companion piece to the review, “Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children,” contains the following pieces:
{"title":"Cochrane in context: Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children","authors":"Tea Andabaka, Maria Ximena Rojas-Reyes","doi":"10.1002/ebch.1951","DOIUrl":"10.1002/ebch.1951","url":null,"abstract":"<p><b>Cochrane Review: Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children</b> Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, Barsic B. Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD006602. DOI: 10.1002/14651858.CD006602.pub4</p><p>This companion piece to the review, “Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children,” contains the following pieces:\u0000\u0000 </p>","PeriodicalId":12162,"journal":{"name":"Evidence-based child health : a Cochrane review journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ebch.1951","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76726844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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