Cochrane Db Syst Rev
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Bipolar disorder is a common recurrent illness with high levels of chronicity. Treatment resistance persists despite the use of established medications, such as lithium and valproate. New medications are required for the treatment of refractory cases. Retrospective and open-label trials have suggested that the anticonvulsant topiramate may be efficacious in bipolar disorder. There is a need to clarify the evidence available in the form of randomised controlled trials for its use in bipolar disorder. ⋯ There is insufficient evidence on which to base any recommendations regarding the use of topiramate in any phase of bipolar illness, either in monotherapy or as an adjunctive treatment.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisRisperidone alone or in combination for acute mania.
Risperidone, an atypical antipsychotic, is used to treat mania both alone and in combination with other medicines. ⋯ Risperidone, as monotherapy and adjunctive treatment, is effective in reducing manic symptoms. The main adverse effects are weight gain, extrapyramidal effects and sedation. Risperidone is comparable in efficacy to haloperidol. Higher quality trials are required to provide more reliable and precise estimates of its costs and benefits.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisProton pump inhibitor treatment for acute peptic ulcer bleeding.
Randomised controlled trials (RCTs) evaluating the clinical effect of proton pump inhibitors (PPIs) in peptic ulcer (PU) bleeding yield conflicting results. ⋯ PPI treatment in PU bleeding reduces rebleeding and surgery compared with placebo or H(2)RA, but there is no evidence of an overall effect on all-cause mortality.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisMedia-based behavioural treatments for behavioural problems in children.
Many approaches are used to address behavioural problems in childhood including medication or, more usually, psychological treatments either directly with the child and/or his/her family. Behavioural and cognitive-behavioural interventions have been shown to be highly effective but access to these treatments is limited due to factors such as time and expense. Presenting the information parents need in order to manage these behaviour problems in booklet or other media-based format would most likely reduce the cost and increase access to these interventions. ⋯ These formats of delivering behavioural interventions for carers of children are worth considering in clinical practice. Media-based interventions may, in some cases, be enough to make clinically significant changes in a child's behaviour, and may reduce the amount of time primary care workers have to devote to each case. They can also be used as the first stage of a stepped care approach. Consequently this would increase the number of families who could possibly benefit from these types of intervention, releasing clinician time that can be reallocated to more complex cases. Media-based therapies would therefore appear to have both clinical and economic implications as regards the treatment of children with behavioural problems.
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Cochrane Db Syst Rev · Jan 2006
ReviewAntibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis.
Lower respiratory tract infection with Pseudomonas aeruginosa (P. aeruginosa) occurs in most people with cystic fibrosis. Once chronic infection is established, P. aeruginosa is virtually impossible to eradicate and is associated with increased mortality and morbidity. Early infection may be easier to eradicate. ⋯ From the three trials included in this review, there is some evidence that antibiotic treatment of early P. aeruginosa results in short-term eradication but it remains uncertain whether there is clinical benefit to people with cystic fibrosis.