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Evidence on interventions for paracetamol (acetaminophen) overdose patients is weak

Poisoning with paracetamol (acetaminophen) is a common cause of hepatic injury. The evidence for all interventions for paracetamol overdose is weak. Activated charcoal, gastric lavage, and ipecacuanha are able to reduce absorption of paracetamol if started within one to two hours of paracetamol ingestion, but the clinical benefit is unclear. Activated charcoal seems to be the best choice if the patient is compliant. N‐acetylcysteine seems superior to no intervention and other antidotes (dimercaprol, cysteamine) and should be administered to patients at significant risk of hepatic damage. However, N‐acetylcysteine superiority to methionine is unclear. Liver transplantation will clearly benefit patients with irreversible hepatic failure. However, identifying such patients early is problematic and the long‐term outcomes in this group of patients have not been reported. Other interventions have not shown any clinical benefit for paracetamol overdose.

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

Version: 2009

Self-Harm: The Short-Term Physical and Psychological Management and Secondary Prevention of Self-Harm in Primary and Secondary Care

This guideline has been developed to advise on the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. The guideline recommendations have been developed by a multidisciplinary group of healthcare professionals, patients and their representatives, and researchers after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those people who self-harm while also emphasising the importance of the experience of care for service users and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2004
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Review article: the management of paediatric nonalcoholic fatty liver disease

BACKGROUND: Paediatric nonalcoholic fatty liver disease (NAFLD) is a major public health concern given the recent increase in its prevalence and link to obesity and other metabolic comorbidities. Current treatment strategies involve lifestyle changes. Other surgical and pharmacologic interventions have been proposed; however, limited randomised controlled trials (RCTs) in the paediatric population restrict their use.

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

Version: 2014

Systematic Reviews in PubMed

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