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BMJ Clinical Evidence UPDATE

Written by admin on Feb 29th, 2008 | Filed under: evidence based medicine UPDATE

Constipation, haemorrhoids, and heartburn in pregnancy (NEW)
New options added for bulk-forming laxatives, increased fibre intake, increased fluid intake, osmotic laxatives, stimulant laxatives, rutosides, anaesthetics (topical), compound corticosteroids plus anaesthetics (topical), corticosteroids (topical), sitz baths, antacids with or without alginates, acid-suppressing drugs, raising the head of the bed, reducing caffeine intake, reducing the intake of fatty foods, and reducing the size and frequency of meals.

Retinal detachment (NEW)
New options added for cryotherapy, laser photocoagulation, scleral buckling v other surgical techniques, and fuorouracil plus heparin. New evidence: conclusion changed for different substances for tamponade.

Cluster headache (NEW)
New options added for sumatriptan (subcutaneous, intranasal) for aborting cluster headache, high-dose and high-flow-rate oxygen, octreotide (subcutaneous), zolmitriptan (oral), hyperbaric oxygen, lidocaine (intranasal), sumatriptan (oral) for aborting cluster headache, greater occipital nerve injections (betamethasone plus xylocaine), Llthium (oral), corticosteroids (oral), verapamil, baclofen (oral), botulinum toxin, capsaicin (intranasal), chlorpromazine, civamide (intranasal), clonidine (transdermal), ergotamine and dihydroergotamine (oral or intranasal), gabapentin (oral), leuprolide, melatonin, methysergide (oral), pizotifen (oral), sodium valproate (oral), sumatriptan (oral) for preventing cluster headache, topiramate (oral), and tricyclic antidepressants.

Trigeminal neuralgia
New options added for microvascular decompression and peripheral laser surgery. New evidence: conclusion changed for baclofen.

HIV: mother-to-child transmission
New evidence: conclusion confirmed for antiretroviral drugs, different methods of infant feeding and vitamins.

Ear wax
New evidence: conclusion confirmed for manual removal.



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