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Hydroxyzine is an anti‐histamine medication that has been studied in anxiety disorders. This review shows that hydroxyzine is better than placebo in terms of anxiety symptoms in individuals with generalised anxiety disorder (GAD). Too few data were available to be able to draw any conclusions about the efficacy and tolerability of hydroxyzine compared with benzodiazepines and buspirone. Given the robust evidence for the efficacy of antidepressants for GAD, these findings suggest that hydroxyzine should not be recommended as first‐line treatment GAD.

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

Version: 2011

Fear of the dentist may be expressed as unco‐operative behaviour in children requiring dental treatment. Behaviour management problems can result in a child's tooth decay going untreated. While behavioural techniques play an important role in managing children, some children still find it difficult to co‐operate with dental treatment and may require sedation. This review examined the effectiveness of drugs to sedate a child whilst keeping them conscious. There is some weak evidence that midazolam administered in a drink of juice is effective, and nitrous oxide (laughing gas) may also be effective.

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

Version: 2012

Women's experience of pain during labour varies greatly. Some women feel little pain whilst others find the pain extremely distressing.  A woman’s position in labour, mobility, and levels of fear and anxiety or, conversely, confidence may influence her experience of pain. Several drug and non‐drug interventions are available for managing pain during labour. In this review we have assessed the evidence on the effectiveness and safety of non‐opioid drugs in the management of pain in labour. Non‐opioid drugs are used to control mild to moderate pain and include non‐steroidal anti‐inflammatory drugs, paracetamol, antispasmodics, sedatives and antihistamines. In the past, these drugs were used to help reduce women's anxiety and thus aid pain relief. Currently, they are not commonly used for pain relief in labour. However, they may still however be offered during the early stages of labour in some countries.

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

Version: 2012

Chronic spontaneous urticaria (CSU) is a condition characterised by a rash of red itchy raised weals or hives, which appear for no identifiable reason. Other names include chronic idiopathic or chronic ordinary urticaria. 'Spontaneous' differentiates this type of urticaria from 'inducible' or 'physical' urticaria, for which there are specific triggers such as cold or pressure. 'Chronic' indicates that the condition has continued for at least six weeks. Hives may be intensely itchy, and the appearance may be unsightly and distressing to sufferers. In some cases, hives can be accompanied by deeper swelling, known as angio‐oedema, which is most common around the eyes and mouth.

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

Version: 2017

Study found evidence that some treatments (ginger, vitamin B6, antihistamines, metoclopramide) were better than placebo for mild symptoms of nausea and vomiting in pregnancy (NVP), but there is little on the effectiveness of treatments in more severe NVP/hyperemesis gravidarum.

Health Technology Assessment - NIHR Journals Library.

Version: October 2016

This guideline has been developed to advise on supporting people with dementia and their carers in health and social care. The guideline recommendations have been developed by a multidisciplinary team of health and social care professionals, a person with dementia, carers and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to practitioners and service commissioners in providing and planning high-quality care for those with dementia while also emphasising the importance of the experience of care for people with dementia and carers.

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

Version: 2007

Antihistamines inhibit the effects of histamine at H1 receptors. They have a number of clinical indications including allergic conditions (e.g., rhinitis, dermatoses, atopic dermatitis, contact dermatitis, allergic conjunctivitis, hypersensitivity reactions to drugs, mild transfusion reactions, and urticaria), chronic idiopathic urticaria (CIU), motion sickness, vertigo, and insomnia.

Drug Class Reviews - Oregon Health & Science University.

Version: May 2010

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

The purpose of this rapid review was to assess the available evidence regarding the clinical effectiveness of sedation and/or anesthesia options in patients undergoing diagnostic procedures who are required to be still. Furthermore, guidelines on sedation and anesthesia in patients undergoing diagnostic procedures were identified and assessed.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: May 8, 2015

Inadvertent perioperative hypothermia is a common but preventable complication of perioperative procedures, which is associated with poor outcomes for patients. Inadvertent perioperative hypothermia should be distinguished from the deliberate induction of hypothermia for medical reasons, which is not covered by this guideline.

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

Version: April 2008

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

This clinical guideline is an update of NICE’s previous guidance on generalised anxiety disorder. It was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out clear evidence- and consensus-based recommendations for healthcare professionals on how to treat and manage generalised anxiety disorder in adults.

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

Version: 2011

Eczema is a common chronic disease. Itch is the most important symptom, and eczema is often accompanied by dry skin. Skin lesions include rash, redness, swelling of the skin, crusts, oozing, and sometimes also bleeding as a consequence of persistent scratching. Although the disease can resolve during childhood, it might also recur in or persist into adult life. The cause of eczema is considered to be a combination of genetic and environmental factors. Moisturisers, topical corticosteroids, and topical immunomodulators are the mainstay during treatment of eczema, while more severe cases might need UV light therapy or systemic immunosuppressants. Itch is very difficult to treat and leads to scratching, which leads to more inflammation of the skin, and often people with eczema end up in a vicious circle of itching and scratching. The role of histamine in itching associated with eczema is not fully elucidated, but oral H1 antihistamines have been used for many years in the treatment of eczema. These might have been used largely for their sedative action, with highly sedative antihistamines, e.g. chlorpheniramine and hydroxyzine. However, oral H1 antihistamines are widely used in the treatment of allergic disorders, such as urticaria, allergic rhinitis, and allergic conjunctivitis, but their efficacy in alleviating itch and eczema remains unclear. This systematic review sought evidence for the effects and safety of the use of oral antihistamines for eczema, to guide their use in clinical practice.

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

Version: 2016

Pruritus is the medical term for itching. This symptom can be a problem in palliative care settings where treatments for cancer or severe kidney disease are given at the same time. In this updated review, we searched for high quality clinical trials of drugs for preventing or treating itch in palliative care.

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

Version: 2016

The use of benzodiazepines has been associated with several adverse effects including, ataxia, dizziness, over-sedation, anterograde amnesia, and dependence. The severity of adverse effects, particularly those associated with the central nervous system, may be greater in older adults. Therefore, close monitoring is typically recommended when benzodiazepines are used by older adults. In addition, several reviews and guidelines recommend that the use of long-acting benzodiazepines by older adults be avoided. High utilization by older adults and documented safety concerns indicate that a review of the evidence on the use of benzodiazepines by older adults is warranted.

Rapid Response Report: Peer-Reviewed Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 2011

The guideline on Drug misuse: opioid detoxification, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence-based recommendations for healthcare staff on how to work with people who misuse opioids to significantly improve their treatment and care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.

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

Version: 2008

Lysosomal storage diseases (LSDs) comprise about 50 unique monogenic autosomal or X-linked diseases with an estimated combined incidence of 1 in 7,000 to 8,000 live births. They occur secondary to genetic mutations that result in deficiency or reduced activity of native intracellular enzymes that catabolize biological macromolecules. These enzyme defects result in accumulation of specific macromolecular compounds within lysosomes in various tissues and organs, causing progressive damage that can become life-threatening in some diseases. LSD management traditionally involved supportive care measures tailored to disease stage, the organs and systems involved, and the degree of impairment. However, enzyme-replacement therapy (ERT) is now commercially available for six LSDs, typically used lifelong with traditional management practices for each.

Technical Briefs - Agency for Healthcare Research and Quality (US).

Version: January 2013

The study found that there is uncertainty over whether or not educational interventions that address issues that could improve health-related quality of life in people with chronic skin conditions are effective. Tentative conclusions about the best approach to deliver these kinds of interventions are that face-to-face group sessions may be beneficial; however, text messages may also be effective. Delivery over a period of time and by a multidisciplinary team may also be associated with positive outcomes. There is uncertainty over whether or not educational interventions are cost-effective. Priorities for research are high-quality, adequately powered randomised controlled trials that evaluate theory-based interventions and include an adequate long-term follow-up in all chronic inflammatory skin conditions.

Health Technology Assessment - NIHR Journals Library.

Version: October 2015

Hepatitis C virus (HCV) infection is caused by an enveloped, single-stranded, linear ribonucleic acid (RNA) virus of the Flaviviridae family. Before 2011, pegylated interferon plus ribavirin (PR) was the gold standard of therapy to inhibit viral replication in patients with chronic hepatitis C (CHC). Approximately one-half of patients with genotype 1 CHC, the most prevalent type of CHC in Canada, could expect to achieve a sustained viral response (SVR) with PR therapy.

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.

Version: November 2016

We systematically reviewed evidence on psychosocial and/or pharmacologic treatment for children with disruptive behavior disorders.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: October 2015

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