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Antibiotics for community‐acquired pneumonia in adolescent and adult outpatients

This review studied the effects of antibiotics on adolescents and adults with pneumonia acquired and treated in the community (as opposed to acquiring pneumonia in hospital and/or being treated for pneumonia in hospital). The evidence is current to March 2014.

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

Version: 2014

Preventing eating disorders in children and adolescents

Eating disorders represent an extremely difficult, time‐consuming and costly condition to treat. Being young, female, and dieting are some of the few identified risk factors that have been reliably linked to the development of eating disorders. Several eating disorder prevention programs have been developed and trialled with children and adolescents. There is currently limited evidence in the published literature to suggest that any particular type of program is effective in preventing eating disorders and there has been concern that some interventions have the potential to cause harm. The aim of this systematic review is to determine whether these interventions are effective in the prevention of eating disorders in children and adolescents. Only one statistically significant result was found in the present meta‐analysis ‐ a slight effect of media literacy and advocacy programs in reducing acceptance of societal body image ideals. There is not sufficient evidence to suggest that harm was caused by any of the 12 randomised controlled trials included in the review at short‐term follow‐up. The meta‐analysis is in the process of being revised to account for the impact of cluster randomised trials.

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

Version: 2009

Behavioural and cognitive‐behavioural therapy for obsessive‐compulsive disorder (OCD) in children and adolescents

The onset of obsessive‐compulsive disorder often occurs in childhood and adolescence. Paediatric OCD can be an extremely debilitating disorder, resulting in high levels of distress, impairment and disruption of psychosocial development. It also has a considerable impact on other family members. While there is evidence that medication can reduce symptoms, behavioural and cognitive‐behavioural therapy (BT/CBT) are often proposed as acceptable alternative treatments. These therapies include assisting the child to better tolerate the anxiety‐provoking situations and thoughts without the use of compulsive behaviour to manage their anxiety, psycho‐educationabout anxiety and OCD; cognitive therapy in which the child is helped to learn to identify and challenge unhelpful ways of thinking; and parental support.

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

Version: 2010

Music education for improving reading skills in children and adolescents with dyslexia

Despite having average or above average intelligence, people with dyslexia (or developmental dyslexia or specific reading disability) have difficulties with accurate or fluent recognition of words (or both) and poor spelling that cannot be attributed to another cause, such as poor vision or hearing or a lack of teaching or motivation. As a consequence of their difficulties, children and adolescents with dyslexia may experience early academic failure. Some studies suggest that reading skills and musical abilities might be related and that musical training may be able to help in the development of language and literacy skills. As information about the effectiveness of musical learning for children and adolescents is lacking, we searched widely for high‐quality evidence in the form of randomized controlled trials. We did not find any and so it is not possible for us to reliably assess the advantages (or even disadvantages) of music education for improving the reading skills of dyslexic children. Well‐designed research with a large number of participants is required to evaluate potential benefits of musical education for children and adolescents with dyslexia.

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

Version: 2012

Controlled studies for treatment of dysarthia associated with acquired brain injury in childhood urgently required

Dysarthria is a disorder of speech production that can make it harder for people to be understood by others.  Dysarthria is a common and often chronic outcome associated with brain injury suffered in childhood (also known as paediatric acquired brain injury (ABI) ).

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

Version: 2008

Comparing initial antiretroviral regimens stavudine or zidovudine as part of three‐drug combinations for treatment of HIV infection

The introduction of highly active antiretroviral therapy (ART) as treatment for HIV infection has greatly improved mortality and morbidity for adults and adolescents living with HIV around the world. Deciding which treatment regimen to begin for first‐line treatment in ART‐naïve patients, however, remains a significant challenge. Two of the most commonly used medications include stavudine (d4T) and zidovudine (AZT). The purpose of this review was to assess which of these two medications was the best for initial treatment for people living with HIV, and through our search we identified nine randomised controlled trials. Overall, these studies showed no critical difference between d4T and AZT. Future studies and recommendations should focus on specific toxicities and tolerability when comparing these two medications.

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

Version: 2011

Meditation therapies for attention‐deficit/hyperactivity disorder (ADHD)

Attention‐deficit/hyperactivity disorder (ADHD) is a disorder that affects a significant number of children and adults in a variety of ways. It is characterized by chronic levels of inattention, impulsiveness and hyperactivity. Meditation therapy could be a beneficial treatment for those diagnosed with ADHD. The objective of this review was to assess the efficacy of this treatment. As a result of the small number of studies that we were able to include in this review and the limitations of those studies, we were unable to draw any conclusions regarding the effectiveness of meditation therapy for ADHD. No adverse effects of meditation in children have been reported. More trials are needed on meditation therapies for ADHD so that conclusions can be drawn regarding its effectiveness.

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

Version: 2010

Short courses of antibiotics (2‐4 days) are as effective as longer treatment for bladder infections in children.

Bladder and kidney infections (urinary tract infections ‐ UTI) are common in children. Bladder infections cause pain on passing urine and frequency of urination. Some children keep getting repeat bouts. Standard courses of antibiotics (7‐10 days) are used to clear the infection. Shorter courses may reduce adverse effects and costs, but there has been concern that they might reduce the chances of clearing the infection and increase the risk of recurrence. A review of studies found that short courses of antibiotics (2‐4 days) used for bladder infections are as effective as standard courses at clearing UTI, with no increase in recurrence.

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

Version: 2010

Recombinant growth hormone for children and adolescents with Turner syndrome

Turner syndrome (TS) is a genetic disorder affecting the sexual development and appearance of girls and women. Women with TS are much shorter than other women (by about 21 cm or eight inches). To try to overcome slow growth, recombinant growth hormone (hGH) has been given. The hormone is injected under the skin several times a week until final adult height is achieved. The review found some evidence that hGH does increase short‐term growth in girls with TS and adult height (an increase of perhaps five centimeters or two inches). However, girls treated with hGH are still substantially shorter than other women as adults. Final height in 61 treated women was 148 cm and 141 cm in 43 untreated women.

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

Version: 2009

Signs of depression

It is not always easy to diagnose depression. Several typical symptoms lasting for more than two weeks may be a sign that someone is depressed. In children and teenagers, however, depression often has different symptoms.We all experience deep sadness and anxiety every now and again, especially when faced with a particularly challenging or painful situation in life. That can sometimes lead to depression. Depression is more than simply feeling blue or having a bad day. Typical symptoms include long periods of feeling down, lack of motivation and lack of interest. People no longer enjoy things they used to enjoy, find it difficult to work or study, and neglect their friends and family.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 12, 2017

Antibiotics for lower urinary tract infection in children

Urinary tract infection (UTI) is one of the most common bacterial infections in infants and children. The most commonly presenting infection of the urinary tract is known as cystitis and in the majority of cases can be easily treated with a course of antibiotic therapy with no further complications. This review identified 16 studies investigating antibiotics for UTI in children. Results suggest that 10‐day antibiotic treatment is more likely to eliminate bacteria from the urine than single‐dose treatments; there was not enough data to draw conclusions about other treatment durations, or effectiveness of particular antibiotics. Although antibiotic treatment is effective for children with UTI, there are insufficient data to recommend any specific regimen.

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

Version: 2014

Ways to reduce risky sexual behaviour in homeless youth to prevent HIV

There have been a limited number of  rigorously conducted interventions to modify the sexual behaviour of homeless youth 12‐24 years of age to prevent them from acquiring HIV.  More research is required to identify effective strategies for this population. In this review, we systematically searched published and unpublished accounts of interventions that had been rigorously tested . We found three eligible independently conducted randomised controlled trials testing three different interventions. All three were conducted in the United States, amongst a total of 615 homeless, male and female youth. Due to the varied delivery of interventions, outcome measurement and reporting, we were unable to aggregate outcomes to estimate summary of effect measures. The significant risk of bias associated with the three included studies and their heterogeneity necessitate caution in interpreting the effectiveness of interventions to modify sexual risk behaviour for preventing HIV in homeless youth. While studies among homeless youth are highly challenging, future trials should comply with rigorous methodology in design, delivery, outcome measurement and reporting as well as consider the changing facets of homeless youth when designing HIV prevention tools.

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

Version: 2011

Metformin added to insulin therapy for type 1 diabetes mellitus in adolescents

Diabetes mellitus is a metabolic disorder resulting from a defect in insulin secretion, insulin action, or both. Metabolic control (glycaemic control, that is long‐term blood glucose levels as measured by glycosylated haemoglobin A1c (HbA1c)) often deteriorates during puberty in children with type 1 diabetes possibly due to the development of insulin resistance (insulin does not work effectively in the tissues anymore) and this creates a great need for alternative therapeutic strategies in those patients. We searched for randomised controlled trials of good quality that studied the effects of metformin added to insulin therapy for type 1 diabetes mellitus in adolescents on glycaemic control, insulin sensitivity, health‐related quality of life, side‐effects as well as effects on body weight, serum lipids and insulin dose.

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

Version: 2009

Tricyclic antidepressant medication for treating children and adolescents with an autism spectrum disorder

Autism spectrum disorders (ASD) are characterised by problems with social interaction and verbal and non‐verbal communication, as well as restricted and repetitive interests and behaviours. Tricyclic antidepressants (TCAs) are medications that alter the level of the neurotransmitter serotonin and have been used in the treatment of autistic symptoms, anxiety and obsessive‐compulsive type behaviours. We found three trials that studied two different TCAs ‐ clomipramine and tianeptine. One of the clomipramine studies involved children and young adults; the other two studies enrolled only children. All three trials were small, with between 12 and 32 participants. There is only limited evidence to support the use of clomipramine or tianeptine in the treatment of individuals with ASD, and some evidence of side effects that would limit their usefulness. Clinicians considering the use of TCAs in ASD need to be aware of the limited and conflicting evidence of effect and the side effect profile of TCAs when discussing this treatment option with patients with ASD and their carers. More research is required before TCAs can be recommended for use in ASD.

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

Version: 2012

Orthodontic and orthopaedic treatment for anterior open bite in children

Interventions were able to correct anterior open bite but this was based on data from two studies that have problems in their quality.

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

Version: 2014

Counselling and education interventions for promoting adherence to treatment for tuberculosis

Many people do not take their medication as prescribed. The consequences of this for chronic and debilitating infections like tuberculosis are serious and can include prolonged periods of infectiousness, relapse, emergence of drug‐resistant Mycobacterium tuberculosis isolates, and increased morbidity and mortality. Our review considered trials of education and counselling in promoting adherence to the treatment of both latent (dormant) and active tuberculosis.

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

Version: 2012

The use of oral protein calorie supplements in children with chronic disease

A lack of growth and poor nutrition are common in children with chronic diseases like cystic fibrosis and paediatric cancer. This may be due to reduced appetite, poor absorption and the need for extra calories due to the disease. Oral protein calorie supplements, either as milk or juices, may improve nutritional status and help children gain weight. Side effects of taking these supplements include the risk that the protein and calories in the supplement end up replacing those from normal food and have a negative effect on eating behaviour and physical side effects (e.g. bloating, vomiting and diarrhoea).

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

Version: 2015

Health care services instead of admission to hospital for young people or children with mental health problems

Many countries place emphasis on providing mental health services in the least restrictive setting, recognizing that some children will need to be admitted to hospital.  As a result there are a range of mental health services to manage young people with serious mental health problems in community or outpatient settings who are at risk of being admitted to hospital.

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

Version: 2009

Iron supplements for children living in malaria‐endemic countries

Children living in malarial areas commonly develop anaemia. Long‐term anaemia is thought to delay a child's development and make children more likely to get infections. In areas where anaemia is common, health providers may give iron to prevent anaemia, but there is a concern amongst researchers that this may increase the risk of malaria. It is thought that the iron tablets will increase iron levels in the blood, and this will promote the growth of the Plasmodium parasite that causes malaria. We aimed to assess the effects of oral iron supplementation in children living in countries where malaria is common.

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

Version: 2016

Different combinations of inhaled steroids and long‐acting beta‐agonists for chronic asthma (fluticasone/salmeterol versus budesonide/formoterol)

People with persistent asthma often require an additional treatment to regular inhaled steroids. Some preparations of long‐acting beta‐agonists are delivered in the same inhaler device as the inhaled corticosteroids. Inhaled steroids help to treat inflammation of the airway and long‐acting beta‐agonists help the airway to relax, improving symptoms and lung function. This systematic review examined randomised controlled trials comparing two commonly available combinations administered at a fixed dose through a single inhaler, fluticasone/salmeterol and budesonide/formoterol. We included five studies which recruited 5537 people. The trials were generally well designed but only recruited adults and adolescents and not children. Participants were already taking regular inhaled steroids before the studies commenced and had mild or moderate asthma based on tests of their airway. We found that the number of people who required treatment with oral steroids and admission to hospital was similar between the treatments, but due to the statistical uncertainty of this result we could not rule out important differences in favour of either drug combination. Additional trials would enable us to draw more reliable conclusions about how well these drugs work compared with each other. We also looked at serious adverse events. Again, the results did not indicate that one combination was clearly better than the other, but again these results were imprecise so we cannot be certain. However, lung function and rescue medication use were similar between the treatments. We could not assess the relative effects of these drugs on mortality because there were so few deaths which leads to statistical uncertainty; out of the five studies, one person died. Quality of life was measured in different ways in two studies and we could not determine how the treatments compared in this respect. Further studies are needed to strengthen and better explain these findings. In particular studies which assess the effects of these therapies in children and studies which measure quality of life are a priority.

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

Version: 2012

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