Abstract:
BACKGROUND:Injecting drug users are vulnerable to infection with HIV and other blood borne viruses as a result of collective use of injecting equipment as well as sexual behaviour. OBJECTIVES:To assess the effect of oral substitution treatment for opioid dependent injecting drug users on rates of HIV infections, and high risk behaviours. SEARCH STRATEGY:Multiple electronic databases were searched. Reference lists of retrieved studies, reviews and conference abstracts were handsearched. SELECTION CRITERIA:Studies were required to consider the incidence of risk behaviours, or the incidence of HIV infection related to substitution treatment of opioid dependence. All types of original studies were considered. DATA COLLECTION AND ANALYSIS:Each potentially relevant study was independently assessed by two reviewers. For studies that met the inclusion criteria, key information was extracted by one reviewer and confirmed by consultation between all four reviewers. MAIN RESULTS:Twenty-eight studies, involving 7900 participants, were included. The majority were not randomised controlled studies. Issues of confounding and bias are discussed. The studies varied in several aspects limiting the extent of quantitative analysis. REVIEWERS' CONCLUSIONS:Oral substitution treatment for opioid-dependent injecting drug users is associated with statistically significant reductions in illicit opioid use, injecting use and sharing of injecting equipment. It is also associated with reductions in the proportion of injecting drug users reporting multiple sex partners or exchanges of sex for drugs or money, but has little effect on condom use. It appears that the reductions in risk behaviours related to drug use do translate into reductions in cases of HIV infection. The lack of data from randomised controlled studies limits the strength of the evidence presented in this review. However, these findings add to the stronger evidence of effectiveness of substitution treatment on drug use, and treatment retention outcomes shown by other systematic reviews. On this basis, the provision of substitution treatment for opioid dependence in countries with emerging HIV and injecting drug use problems as well as in countries with established populations of injecting drug users should be supported.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Gowing L,Farrell M,Bornemann R,Ali Rdoi
10.1002/14651858.CD004145.pub2keywords:
subject
Has Abstractpub_date
2004-10-18 00:00:00pages
CD004145issue
4issn
1469-493Xpub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Many hormonal contraceptives have been associated with changes in carbohydrate metabolism. Alterations may include decreased glucose tolerance and increased insulin resistance, which are risk factors for Type 2 diabetes mellitus and cardiovascular disease. These issues have been raised primarily with contrac...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006133.pub5
更新日期:2014-04-30 00:00:00
abstract:BACKGROUND:Cystic fibrosis is a life-limiting autosomal recessive genetic illness. A feeling of shortness of breath is common in cystic fibrosis, especially as the disease progresses. Reversing the underlying cause is the priority when treating breathlessness (dyspnoea), but when it is not feasible, palliation (easing)...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
doi:10.1002/14651858.CD011855.pub3
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abstract:BACKGROUND:Patients with cystic fibrosis, who are chronically colonised with the organism Pseudomonas aeruginosa, often require repeated courses of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations. The properties of aminoglycosides suggest that they could be given in higher concentra...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002009
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:To assess the effects of providing pregnant women with high-protein nutritional supplements on gestational weight gain and on the outcome of pregnancy, including fetal growth, gestational duration, and maternal and fetal/infant morbidity and mortality. SEARCH STRATEGY:The register of clinical trials maintai...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000105
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Premenstrual syndrome (PMS) is a common problem. Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome. Combined oral contraceptives, which provide both progestin and estrogen, have been examined for their ability to relieve premenstrual symptoms. An oral contraceptive containing d...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006586.pub4
更新日期:2012-02-15 00:00:00
abstract:BACKGROUND:Rubefacients (containing salicylates or nicotinamides) cause irritation of the skin, and are believed to relieve various musculoskeletal pains. They are available on prescription, and are common components in over-the-counter remedies. A non-Cochrane review in 2004 found limited evidence for efficacy. OBJEC...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD007403.pub2
更新日期:2009-07-08 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD000116.pub2
更新日期:2006-07-19 00:00:00
abstract:BACKGROUND:Yoga is an ancient spiritual practice that originated in India and is currently accepted in the Western world as a form of relaxation and exercise. It has been of interest for people with schizophrenia to determine its efficacy as an adjunct to standard-care treatment. OBJECTIVES:To examine the effects of y...
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doi:10.1002/14651858.CD010554.pub2
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doi:10.1002/14651858.CD011770.pub2
更新日期:2017-11-09 00:00:00
abstract:BACKGROUND:Acute lateral ankle ligament injuries (ankle sprains) are common problems in acute medical care. The treatment variation observed for the acutely injured lateral ankle ligament complex suggests a lack of evidence-based management strategies for this problem. OBJECTIVES:The objective of this review was to as...
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doi:10.1002/14651858.CD003762
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Group A streptococcus (GAS) accounts for 20% to 40% of cases of pharyngitis in children; the remaining cases are caused by viruses. Compared with throat culture, rapid antigen detection tests (RADTs) offer diagnosis at the point of care (within five to 10 minutes). OBJECTIVES:To determine the diagnostic acc...
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD010502.pub2
更新日期:2016-07-04 00:00:00
abstract:BACKGROUND:Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instrumen...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002766.pub4
更新日期:2016-05-03 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD007461.pub3
更新日期:2014-10-28 00:00:00
abstract:BACKGROUND:Chronic neutrophilic inflammation, both in the presence and absence of infection, is a feature of bronchiectasis in adults and children. The anti-inflammatory properties of non-steroid anti-inflammatory drugs (NSAIDs) may be beneficial in reducing airway inflammation and thus potentially improve lung functio...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD007525.pub2
更新日期:2010-04-14 00:00:00
abstract:BACKGROUND:Children's exposure to other people's tobacco smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children in child care or educational settings are also at risk of exposure to...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001746.pub4
更新日期:2018-01-31 00:00:00
abstract:BACKGROUND:Foot ulcers in people with diabetes mellitus are a common and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having many different types to choose from including alginate dressings. A clear and current overview of current evidence is required to facili...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009110.pub2
更新日期:2012-02-15 00:00:00
abstract:BACKGROUND:Reconstruction of the anterior cruciate ligament (ACL) commonly involves patellar tendon (PT) or hamstring tendon(s) (HT) autografts. There is no consensus with respect to the choice between these two grafts in ACL surgery. OBJECTIVES:This review compared the outcomes of ACL reconstruction using PT versus H...
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005960.pub2
更新日期:2011-09-07 00:00:00
abstract:BACKGROUND:Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. OBJECTIVES:To assess the effe...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008194.pub3
更新日期:2014-11-26 00:00:00
abstract::This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia, including: evaluating the effects of using compu...
journal_title:The Cochrane database of systematic reviews
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doi:
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abstract:BACKGROUND:Early enteral nutrition support (within 48 hours of admission or injury) is frequently recommended for the management of patients in intensive care units (ICU). Early enteral nutrition is recommended in many clinical practice guidelines, although there appears to be a lack of evidence for its use and benefit...
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doi:10.1002/14651858.CD005049.pub5
更新日期:2019-09-04 00:00:00
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doi:10.1002/14651858.CD003974.pub2
更新日期:2004-01-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2016-02-10 00:00:00
abstract:BACKGROUND:Motor control exercise (MCE) is used by healthcare professionals worldwide as a common treatment for low back pain (LBP). However, the effectiveness of this intervention for acute LBP remains unclear. OBJECTIVES:To evaluate the effectiveness of MCE for patients with acute non-specific LBP. SEARCH METHODS:W...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD012085
更新日期:2016-02-10 00:00:00
abstract:BACKGROUND:Anterior vaginal repair (anterior colporrhaphy) is an operation traditionally used for moderate or severe stress urinary incontinence in women. About a third of adult women experience urinary incontinence. OBJECTIVES:To determine the effects of anterior vaginal repair (anterior colporrhaphy) on stress or mi...
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abstract:BACKGROUND:Tuberculous (TB) pericarditis is becoming more common. The infection can result in fluid around the heart, which can be fatal. OBJECTIVES:To evaluate evidence from trials about the effects of medical and surgical treatments for TB pericarditis on death and life-threatening conditions. SEARCH STRATEGY:The C...
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更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Guillain-Barré syndrome is a potentially serious, acute, paralysing, probably autoimmune disease caused by inflammation of the peripheral nerves. Recovery has been shown to be speeded by plasma exchange which replaces the patient's own plasma with a plasma substitute. Intravenous immunoglobulin purified from...
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更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Propentofylline is a novel therapeutic agent for dementia that readily crosses the blood-brain barrier and acts by blocking the uptake of adenosine and inhibiting the enzyme phosphodiesterase. In vitro and in vivo its mechanism of action appears to be twofold; it inhibits the production of free radicals and ...
journal_title:The Cochrane database of systematic reviews
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更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Steroidal contraceptive use has been associated with changes in bone mineral density in women. Whether such changes increase the risk of fractures later in life is not clear. However, osteoporosis is a major public health concern. Age-related decline in bone mass increases the risk of fracture, especially of...
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更新日期:2006-10-18 00:00:00