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Meta analysis of outcomes of penehyclidine hydrochloride and atropine in treatment of acute organophosphorus poisoning

Bibliographic details: Luo Z, Wei XC, Lin J.  Meta analysis of outcomes of penehyclidine hydrochloride and atropine in treatment of acute organophosphorus poisoning. Chinese Journal of Industrial Hygiene and Occupational Diseases 2010; 28(1): 63-6520426991

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Meta analysis of comparison between atropine and cyclopentolate in cycloplegia

Bibliographic details: Cheng SM, Zhou X, Li Y, Xu L.  Meta analysis of comparison between atropine and cyclopentolate in cycloplegia. Chinese Journal of Experimental Ophthalmology 2012; 30(12): 1135-1138 Available from: http://lib.cqvip.com/qk/92110A/201212/44159234.html

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Atropine in ameliorating the progression of myopia in children with mild to moderate myopia: a meta-analysis of controlled clinical trials

OBJECTIVES: Myopia is the most common ocular disorder associated with increasing risk for chorioretinal degeneration, retinal detachment, and other vision-threatening abnormalities worldwide. Recently, atropine has been becoming a focus of attention due to its role in ameliorating the myopia progression in children. This meta-analysis was conducted to address the efficacy and safety of atropine on myopia in children and the dose-response relationship between atropine and annual rate of myopia progression.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Atropine slows myopia progression more in Asian than White children by meta-analysis

PURPOSE: To conduct a meta-analysis on the effects of atropine in slowing myopia progression and to compare Asian and white children and randomized controlled trials (RCTs) and observational studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Screening for Visual Impairment in Children Ages 1-5 Years: Systematic Review to Update the 2004 U.S. Preventive Services Task Force Recommendation [Internet]

Impaired visual acuity is common in preschool-aged children. Screening for impaired visual acuity in primary care settings could identify children with vision problems at a critical period of visual development and lead to interventions to improve vision, function, and quality of life.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: February 2011
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Sedation in Children and Young People: Sedation for Diagnostic and Therapeutic Procedures in Children and Young People [Internet]

Many children present to hospitals and dental clinics needing effective sedation or anaesthesia for painful or distressing diagnostic or therapeutic procedures. There are many sedation techniques available but there is insufficient guidance on which techniques are effective and what resources are required to deliver them safely. Sedation is not always effective enough and will occasionally require the procedure to be delayed until the child can be anaesthetised perhaps in another healthcare setting or on another day. Consequently sedation failure is both distressing for the child and has major NHS cost implications. Excessive doses of sedation can cause unintended loss of consciousness and dangerous hypoxia. In comparison, planned anaesthesia is effective, but may have resource implications. The need for sedation or anaesthesia will depend upon the type of procedure. Some types of procedures are very common and healthcare providers and practitioners need to understand whether sedation or anaesthesia is the most cost effective method of managing them

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: December 2010
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Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications [Internet]

Alcohol is the most widely used psychotropic drug in the industrialised world; it has been used for thousands of years as a social lubricant and anxiolytic. In the UK, it is estimated that 24% of adult men and 13% of adult women drink in a hazardous or harmful way. Levels of hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the north (26–28% of men, 16–18% of women). Hazardous and harmful drinking are commonly encountered amongst hospital attendees; 12% of emergency department attendances are directly related to alcohol whilst 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels. Continued hazardous and harmful drinking can result in dependence and tolerance with the consequence that an abrupt reduction in intake might result in development of a withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can also result in damage to almost every organ or system of the body. Alcohol-attributable conditions include liver damage, pancreatitis and the Wernicke’s encephalopathy. Key areas in the investigation and management of these conditions are covered in this guideline.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: 2010
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Irritable Bowel Syndrome in Adults: Diagnosis and Management of Irritable Bowel Syndrome in Primary Care [Internet]

This guideline covers areas relevant to the diagnosis and management of irritable bowel syndrome (IBS) reflecting the complete patient journey, from the person presenting with IBS symptoms, positive diagnosis and management, targeted at symptom control. The guideline incorporates Cochrane reviews, published NICE clinical and public health guidance, Health Technology Assessment reports, systematic and health economic reviews produced by the National Collaborating Centre for Nursing and Supportive Care. Recommendations are based on clinical and cost effectiveness evidence, and where this is insufficient, the GDG used all available information sources and experience to make consensus recommendations using nominal group technique.

NICE Clinical Guidelines - National Collaborating Centre for Nursing and Supportive Care (UK).

Version: February 2008
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Drug Class Review: Newer Antiemetics: Final Report Update 1 [Internet]

Nausea and vomiting are major concerns for patients undergoing chemotherapy, radiation therapy and surgery with general anesthesia. Risk factors associated with chemotherapy-induced nausea and vomiting include emetogenicity of the chemotherapy regimen, dose, speed of intravenous infusion, female gender, age under 50 years, history of ethanol consumption, and history of prior chemotherapy. Factors predictive of radiation therapy-induced nausea and vomiting include site of irradiation (in particular, total body irradiation and radiation fields that include the abdomen), total field size, dose per fraction, age, and predisposition for emesis (history of sickness during pregnancy or motion sickness). Female gender, a history of motion sickness or prior postoperative nausea and vomiting, nonsmoking status, and use of postoperative opioids have been suggested as factors predictive of postoperative nausea and vomiting. The objective of this review was to evaluate the comparative effectiveness and harms of newer antiemetic drugs including the 5-HT3 and NK-1 antagonists.

Drug Class Reviews - Oregon Health & Science University.

Version: January 2009
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Treatment of amblyopia (lazy eye) with patching or drops/drug treatment

Amblyopia (referred to as lazy eye) is a common childhood condition, and is defined as defective visual acuity in one or both eyes, which is present with no demonstrable abnormality of the visual pathway and is not immediately resolved by wearing glasses. Treatment for amblyopia usually starts with prescribing necessary glasses to correct visually important refractive errors followed by promoting the use of the amblyopic eye. This systematic review aimed to synthesize the best available evidence regarding the effectiveness and safety of two different treatment options used to promote the use of the amblyopic eye: conventional occlusion (patching) and atropine penalization (drops). Conventional occlusion involves patching the non‐amblyopic eye with an opaque patch for a set number of hours per day. Atropine penalization involves the instillation of atropine sulphate to blur the eyesight of the better‐seeing eye.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Drug Class Review: Agents for Overactive Bladder: Final Report Update 4 [Internet]

Overactive bladder is defined by the International Continence Society as a syndrome of urinary frequency and urgency, with or without urge incontinence, appearing in the absence of local pathological factors. Treatment of overactive bladder syndrome first requires a clear diagnosis. In patients with incontinence, multiple forms can be present and it is important to determine which form is dominant. Non-pharmacologic, non-surgical treatment consists of behavioral training (prompted voiding, bladder training, pelvic muscle rehabilitation), transcutaneous electrical nerve stimulation, catheterization, and use of absorbent pads. Pharmacologic treatment for overactive bladder syndrome includes darifenacin, flavoxate hydrochloride, hyoscyamine, oxybutynin chloride, tolterodine tartrate, trospium chloride, scopolamine transdermal, and solifenacin succinate. The purpose of this systematic review is to compare the benefits and harms of drugs used to treat overactive bladder syndrome.

Drug Class Reviews - Oregon Health & Science University.

Version: March 2009
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Treatment of Overactive Bladder in Women

The Vanderbilt Evidence-based Practice Center systematically reviewed evidence on treatment of overactive bladder (OAB), urge urinary incontinence, and related symptoms. We focused on prevalence and incidence, treatment outcomes, comparisons of treatments, modifiers of outcomes, and costs.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: August 2009
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Use of sodium bicarbonate to treat organophosphorus pesticide poisoning

Many people, particularly in developing countries, are poisoned by organophosphorus pesticides (OPs) used in agriculture or for killing insects in the home. Poisoning may be accidental or intentional. Even when the usual antidotes are given, 10 to 20% of those poisoned still die. Research in animals has suggested that use of sodium bicarbonate (baking soda) or similar chemicals which make the blood alkaline might save people poisoned by OPs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Propofol use for sedation in newborn babies undergoing procedures

Procedures performed in preterm and term neonates can be stressful and at times painful. Medications to reduce stress/pain for babies can lead to side effects. Propofol is a commonly used medication in adults and children to achieve sedation during minor procedures or major operations. Its use in newborn babies is studied in only one study of 63 babies. Propofol helped to reduce time to complete procedure, time of recovery and time to prepare drugs. However, with this small number of newborns studied, the safety can not be proven. Further studies are warranted.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Anticholinergic drugs in subjects with Multiple Sclerosis (MS) and urinary symptoms.

Urinary symptoms are very common in people with multiple sclerosis, reflecting the high prevalence of damage to the spinal cord from MS. Symptoms may change with time due to either progression or MS relapses. Common symptoms include frequency, urgency and urinary incontinence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antidotes for acute cardenolide (cardiac glycoside) poisoning

Cardenolides are naturally occurring plant toxins which act primarily on the heart. While poisoning with the digitalis cardenolides (digoxin and digitoxin) are reported worldwide, cardiotoxicity from other cardenolides such as the yellow oleander are also a major problem, with tens of thousands of cases of poisoning each year in South Asia. Because cardenolides from these plants are structurally similar, acute poisonings are managed using similar treatments. The benefit of these treatments is of interest, particularly in the context of cost since most poisonings occur in developing countries where resources are very limited. The objectives of this review are to determine the efficacy of antidotes for the treatment of acute cardenolide poisoning, in particular atropine, isoprenaline (isoproterenol), multiple‐dose activated charcoal (MDAC), fructose‐1,6‐diphosphate, sodium bicarbonate, magnesium, phenytoin and antidigoxin Fab antitoxin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Clonidine premedication for postoperative pain in children

We reviewed the evidence about the effect of giving clonidine before anaesthesia (that is, as a premedication) on postoperative pain in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Aminophylline for cardiac arrest

Drugs are used to resuscitate patients from cardiac arrest. Aminophylline is a drug that might help patients in cardiac arrest when electrical activity is very slow or absent. Aminophylline may restore blood flow to the heart, improve electrical activity and make other drugs used in resuscitation more effective. We found five studies that included 1254 patients who had this type of cardiac arrest in the prehospital setting. Four of the five studies (1186 patients) were well‐designed studies with low risk of bias. Although no adverse events were reported, aminophylline added to the standard resuscitation practice of paramedics showed no advantage when compared with placebo in these patients. It is not known whether giving aminophylline sooner would be helpful.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

No evidence that oximes are a useful treatment for organophosphate pesticide poisoning

Many thousands of people die every year because of poisoning by organophosphate pesticides. Most of the deaths are in developing countries. Drugs known as oximes are used as part of the standard recommended treatment, even though many doctors have said that they don't seem to have any benefit. This research has produced mixed evidence. Many of the studies had substantial limitations. Generally, the studies done to date do not support the routine use of oximes, however, they cannot exclude that there would be some doses or situations where a benefit would occur. The reviewers found that not enough research has been done to see whether oximes are actually effective or to define the doses that are more likely to be helpful. More research is needed before any firm conclusions can be drawn.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Interventions to treat noisy breathing, or 'death rattle': the unpleasant, gurgling breathing occuring in many patients who are about to die

Approximately half of those relatives and friends who witness it, as well as hospital staff, find the noise of 'death rattle' distressing. For this reason, doctors and nurses try to eliminate the sound using a variety of methods, from changing the position of the patient to giving drugs to stop the noise. The aim of this review is to find out which treatment, if any, is best. Only four of 32 reports identified met the inclusion criteria for this review; none showed a convincing benefit of any single drug over any others. Some treatments may be worth trying but staff should watch carefully for any side effects of the treatment (e.g. agitation or excessively dry mouth). Anxious relatives need explanation, reassurance and discussion about any fears and concerns associated with the terminal phase and 'death rattle'. Research in this difficult area is necessary to understand the cause of the noise, its effect on the patient and those around them and the best ways of managing this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Systematic Reviews in PubMed

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