Abstract:
BACKGROUND:Nosocomial infections continue to be a significant cause of morbidity and mortality among preterm and/or low birth weight (LBW) infants. Preterm infants are deficient in immunoglobulin G (IgG); therefore, administration of intravenous immunoglobulin (IVIG) may have the potential of preventing or altering the course of nosocomial infections. OBJECTIVES:To use systematic review/meta-analytical techniques to determine whether IVIG administration (compared with placebo or no intervention) to preterm (< 37 weeks' postmenstrual age (PMA) at birth) or LBW (< 2500 g birth weight) infants or both is effective/safe in preventing nosocomial infection. SEARCH METHODS:For this update, MEDLINE, EMBASE, CINAHL, The Cochrane Library, Controlled Trials, ClinicalTrials.gov and PAS Abstracts2view were searched in May 2013. SELECTION CRITERIA:We selected randomised controlled trials (RCTs) in which a group of participants to whom IVIG was given was compared with a control group that received a placebo or no intervention for preterm (< 37 weeks' gestational age) and/or LBW (< 2500 g) infants. Studies that were primarily designed to assess the effect of IVIG on humoral immune markers were excluded, as were studies in which the follow-up period was one week or less. DATA COLLECTION AND ANALYSIS:Data collection and analysis was performed in accordance with the methods of the Cochrane Neonatal Review Group. MAIN RESULTS:Nineteen studies enrolling approximately 5000 preterm and/or LBW infants met inclusion criteria. No new trials were identified in May 2013. When all studies were combined, a significant reduction in sepsis was noted (typical risk ratio (RR) 0.85, 95% confidence interval (CI) 0.74 to 0.98; typical risk difference (RD) -0.03, 95% CI 0.00 to -0.05; number needed to treat for an additional beneficial outcome (NNTB) 33, 95% CI 20 to infinity), and moderate between-study heterogeneity was reported (I2 54% for RR, 55% for RD). A significant reduction of one or more episodes was found for any serious infection when all studies were combined (typical RR 0.82, 95% CI 0.74 to 0.92; typical RD -0.04, 95% CI -0.02 to -0.06; NNTB 25, 95% CI 17 to 50), and moderate between-study heterogeneity was observed (I2 50% for RR, 62% for RD). No statistically significant differences in mortality from all causes were noted (typical RR 0.89, 95% CI 0.75 to 1.05; typical RD -0.01, 95% CI -0.03 to 0.01), and no heterogeneity for RR (I2 = 21%) or low heterogeneity for RD was documented (I2 = 28%). No statistically significant difference was seen in mortality from infection; in incidence of necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) or intraventricular haemorrhage (IVH) or in length of hospital stay. No major adverse effects of IVIG were reported in any of these studies. AUTHORS' CONCLUSIONS:IVIG administration results in a 3% reduction in sepsis and a 4% reduction in one or more episodes of any serious infection but is not associated with reductions in other clinically important outcomes, including mortality. Prophylactic use of IVIG is not associated with any short-term serious side effects. The decision to use prophylactic IVIG will depend on the costs and the values assigned to the clinical outcomes. There is no justification for conducting additional RCTs to test the efficacy of previously studied IVIG preparations in reducing nosocomial infections in preterm and/or LBW infants.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Ohlsson A,Lacy JBdoi
10.1002/14651858.CD000361.pub4subject
Has Abstractpub_date
2020-01-29 00:00:00pages
CD000361issn
1469-493Xjournal_volume
1pub_type
杂志文章,meta分析abstract:BACKGROUND:It is standard clinical practice to combine chemotherapy and chest radiotherapy in treating patients with limited-stage small cell lung cancer. However, the best way to integrate both modalities is unclear. OBJECTIVES:To establish the most effective way of combining chest radiotherapy with chemotherapy for ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004700.pub2
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abstract:BACKGROUND:Demodex blepharitis is a chronic condition commonly associated with recalcitrant dry eye symptoms though many people with Demodex mites are asymptomatic. The primary cause of this condition in humans is two types of Demodex mites: Demodex folliculorum and Demodex brevis. There are varying reports of the prev...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD013333.pub2
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abstract:BACKGROUND:People with type 2 diabetes mellitus are at increased risk from cardiovascular disease. Dietary fish oils are known to reduce triglyceride levels, but their impact on cholesterol levels, glycemic control and vascular outcomes are not well known. OBJECTIVES:To determine the effects of fish oil supplementatio...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD003205
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journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD004609.pub2
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abstract:BACKGROUND:Ileocolic anastomoses are commonly performed for right-sided colon cancer and Crohn's disease. The anastomosis may be constructed using a linear cutter stapler or by suturing. Individual trials comparing stapled versus handsewn ileocolic anastomoses have found little difference in the complication rate but t...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD009243.pub3
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abstract:BACKGROUND:The provision of training for foster carers is now seen as an important factor contributing to the successful outcome of foster care placements. It is believed to be associated with enhancing caring attitudes and skills, reducing behaviour problems in foster children, improving relationships between foster c...
journal_title:The Cochrane database of systematic reviews
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abstract:BACKGROUND:Multiple pregnancy is a strong risk factor for preterm birth, and more than 50% of women with a twin pregnancy will give birth prior to 37 weeks' gestation. Infants born preterm are recognised to be at increased risk of many adverse health outcomes, contributing to more than half of overall perinatal mortali...
journal_title:The Cochrane database of systematic reviews
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abstract:BACKGROUND:This is an updated version of the original Cochrane review published in Issue 5, 2015.Cervical cancer is the fourth most common cancer among women worldwide, with estimated 569,847 new diagnoses and 311,365 deaths per year. However, incidence and stage at diagnosis vary greatly between geographic areas and a...
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doi:10.1002/14651858.CD011000.pub3
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abstract:BACKGROUND:Flupenthixol, first made available in the UK in 1965, has been used as a treatment for schizophrenia for decades. OBJECTIVES:To evaluate the absolute clinical effects of flupenthixol for schizophrenia in comparison with placebo. SEARCH METHODS:We searched the Cochrane Schizophrenia Group Trials Register (A...
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abstract:BACKGROUND:This is an update of the Cochrane review 'Neuropsychological rehabilitation for multiple sclerosis' (first published in The Cochrane Library 2011, Issue 11).Cognitive deficits are a common manifestation of multiple sclerosis (MS) and have a significant effect on the patient's quality of life. Alleviation of ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009131.pub3
更新日期:2014-02-11 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005110.pub2
更新日期:2007-10-17 00:00:00
abstract:BACKGROUND:Urinary tract infection (UTI) is the most common hospital-acquired infection. The major associated cause is indwelling urethral catheters. Several measures have been introduced to reduce catheter-associated urinary tract infections (CAUTIs). One of these measures is the introduction of specialised urethral c...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004013.pub4
更新日期:2014-09-23 00:00:00
abstract:BACKGROUND:Plasmodium vivax liver stages (hypnozoites) may cause relapses, prolonging morbidity, and impeding malaria control and elimination. The World Health Organization (WHO) recommends three schedules for primaquine: 0.25 mg/kg/day (standard), or 0.5 mg/kg/day (high standard) for 14 days, or 0.75 mg/kg once weekly...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
doi:10.1002/14651858.CD012656.pub3
更新日期:2020-08-19 00:00:00
abstract:BACKGROUND:Antiepileptic drugs ( AEDs) are used to prevent seizures but are associated with both short and long term adverse effects. When epilepsy is in remission, it may be in the patient's best interest to discontinue medication. However, the optimal timing of AED discontinuation is not known. OBJECTIVES:To quantif...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD001902
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Dysvascularity accounts for 75% of all lower limb amputations in the UK. Around 37% of these are at transfemoral level (mid-thigh), with the majority of people being over the age of 60 and having existing co-morbidities. A significant number of these amputees will be prescribed a lower limb prosthesis for wa...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005260.pub2
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abstract:BACKGROUND:In the previous version of this review, the effectiveness of interventions tailored to barriers to change was found to be uncertain. OBJECTIVES:To assess the effectiveness of interventions tailored to address identified barriers to change on professional practice or patient outcomes. SEARCH STRATEGY:For th...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD005470.pub2
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD002252
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更新日期:2013-03-28 00:00:00
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journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
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更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:The addition of radiotherapy (RT) following breast conserving surgery (BCS) was first shown to reduce the risk of ipsilateral recurrence in the treatment of invasive breast cancer. Ductal carcinoma in situ (DCIS) is a pre-invasive lesion. Recurrence of ipsilateral disease following BCS can be either DCIS or ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000563.pub5
更新日期:2009-07-08 00:00:00
abstract:BACKGROUND:Nystatin is sometimes used prophylactically in patients with severe immunodeficiency or in the treatment of fungal infection in such patients, although its effect seems to be equivocal. OBJECTIVES:To study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to p...
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journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
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更新日期:2003-01-01 00:00:00
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