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 Cochrane Infectious Diseases Group trials register, the Cochrane controlled trials register, Medline, Embase and reference lists of articles; contact with experts in the field. SELECTION CRITERIA:Randomised and quasi-randomised trials of treatments for TB pericarditis. DATA COLLECTION AND ANALYSIS:Two reviewers independently assessed trial quality and extracted data. Meta-analysis using fixed effects models calculated summary statistics, provided there was no significant heterogeneity, and expressed results as relative risk. MAIN RESULTS:Three trials met the inclusion criteria, with a total of 411 participants. Treatments were adjuvant steroids and surgical drainage. Two small trials tested steroids. There were fewer deaths (all causes) in the intervention group, but the numbers were small and the result could have occurred by chance (relative risk [RR] 0.65, 95% confidence interval [CI] 0.36 to 1.16, n = 350). In one trial studying patients with effusion, "cure" was higher in the steroid group (alive and free of disability at 2 years (RR 0.69, 95% CI 0.29 to 0.80, n = 221). One trial examined open surgical drainage compared with conservative management, and showed no impact of surgery on death, but a protective effective against cadiac tamponade (RR 0.04, 95% CI 0.00 to 0.64). REVIEWER'S CONCLUSIONS:Steroids have potentially large impacts on survival, but trials are too small to test this. We believe further placebo controlled trials of steroids are warranted, exploring whether the presence of effusion or fibrosis modifies effects. Surgical options also require further evaluation.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Mayosi BM,Volmink JA,Commerford PJdoi
10.1002/14651858.CD000526keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
CD000526issue
2issn
1469-493Xpii
CD000526pub_type
杂志文章,评审abstract:BACKGROUND:Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give a mechanical support to the cervix and thereby reducing the risk of preterm birth. The effectiveness and safety of this procedur...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008991.pub2
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doi:10.1002/14651858.CD012055
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD008671.pub3
更新日期:2015-07-14 00:00:00
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更新日期:2002-01-01 00:00:00
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doi:10.1002/14651858.CD003855.pub3
更新日期:2016-01-29 00:00:00
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doi:10.1002/14651858.CD004526.pub2
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abstract:BACKGROUND:Post-thrombotic syndrome (PTS) is a long-term complication of deep vein thrombosis (DVT) that is characterised by chronic pain, swelling, and skin changes in the affected limb. One of every three people with DVT will develop post-thrombotic complications within five years. Several non-pharmaceutical measures...
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更新日期:2012-01-18 00:00:00
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更新日期:2019-09-26 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
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更新日期:2000-01-01 00:00:00
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更新日期:2001-01-01 00:00:00
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更新日期:2011-10-05 00:00:00
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更新日期:2016-02-24 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:2016-02-18 00:00:00
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更新日期:2018-08-06 00:00:00
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