Wednesday 28 January 2015

Endometriosis

Evidence Based Reports

Laparoscopic surgery for endometriosis (2014)[Cochrane Library] NEW

A comparison of progestogens or oral contraceptives and gonadotropin-releasing hormone agonists for the treatment of endometriosis: a systematic review (2014)[DARE] NEW

Anti-TNF- treatment for pelvic pain associated with endometriosis. (2013) [Cochrane Library]

Progestagens and anti-progestagens for pain associated with endometriosis. (2012) [Cochrane Library]

Pentoxifylline for endometriosis (2012) [Cochrane Library]

Interventions for women with endometrioma prior to assisted reproductive technology. (2012) [Cochrane Library]

Chinese herbal medicine for endometriosis (2012) [Cochrane Library]

Acupuncture for pain in endometriosis (2011)[Cochrane Library]

Chinese herbal medicine may be beneficial in endometriosis (2011)[Cochrane PEARLS]

Endometriosis (2010)[Clinical Evidence] subcription required

Pre and post-operative medical therapy for endometriosis surgery (2011)[Cochrane Library]

Gonadotrophin-releasing hormone analogues for pain associated with endometriosis (2010)[Cochrane Library]

Interventions for women with endometrioma prior to assisted reproductive technology (2010)[Cochrane Library]

Pentoxifylline versus medical therapies for subfertile women with endometriosis (2009)[Cochrane Library]

Hormone therapy for endometriosis and surgical menopause (2009)[Cochrane Library]

Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery (2009)[Cochrane Library]

Ovulation suppression for endometriosis for women with subfertility (2009)[Cochrane Library]

Laparoscopic surgery for pelvic pain associated with endometriosis (2009)[Cochrane Library]

Medical treatment for rectovaginal endometriosis: what is the evidence?(2009)[DARE]

The effect of second-line surgery on reproductive performance of women with recurrent endometriosis: a systematic review (2009)[DARE]

Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis (2009)[DARE]

The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis (2009)[DARE]

Laparoscopic management of endometriosis: comprehensive review of best evidence (2009)[DARE]

Clinical Guidelines

Endometriosis. (2014) [CKS] updated

Recent articles in core journals

Caesarean section and risk for endometriosis: a prospective cohort study of Swedish registries. (2013) [EvidenceUpdates]

Postoperative levonorgestrel-releasing intrauterine system for pelvic endometriosis-related pain: a randomized controlled trial. (2012) [EvidenceUpdates]

Urinary dysfunction after colorectal resection for endometriosis: results of a prospective randomized trial comparing laparoscopy to open surgery.(2011)[EvidenceUpdates]

Endometriosis and infertility: pathophysiology and management.(2010)[Lancet]

Randomized trial of laparoscopically assisted versus open colorectal resection for endometriosis: morbidity, symptoms, quality of life, and fertility.(2010)[EvidenceUpdates]

Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis.(2009)[EvidenceUpdates]

Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis.(2008)[EvidenceUpdates]

eTextbooks

Emergent Treatment of Endometriosis. (2013) [eMedicine]

Endometriosis (2013)[Mentor]

Endomitriosis (2011)[eMedicine]

Endometriosis in Emergency Medicine(2010)[eMedicine]

Pediatric Endometriosis Surgery(2010)[eMedicine]

Clinical Queries

Is there any information about using HRT in a postmenopausal patient with previous severe endometriosis who has not had a hysterectomy? (2014)[ATTRACT] NEW

Is there any evidence to support the use of progesterone (without oestrogen)for the treatment of menopausal symptoms and/or endometriosis in patient who have undergone a total hysterectomy and BSO? (2012) [ATTRACT]

Can women with active liver disease (autoimmune hepatitis treated with steroids and azathioprine) and abnormal liver function tests, use depot medroxyprogesterone acetate (DMPA) for the treatment of endometriosis? (2012) [FSRH]

Is HRT recommended for a patient on goserelin for endometriosis experiencing menopausal symptoms?(2009)[ATTRACT]

What evidence is there to support that Depo can help women with endometriosis?(2009)[ATTRACT]

In a lady who has had a hysterectomy/bilateral oopherectomy for severe endometriosis with new onset back pain would recurring endometriosis be considered as part of a differential diagnosis?(2008)[ATTRACT]

Does a woman receiving Zoladex implants for endometriosis need to continue her oral contraceptive.(2008)[ATTRACT]

Which regimen of HRT (combined or oestrogen-only) should be prescribed for a patient who recently had an abdominal hysterectomy bilateral salpingo-oophorectomy and who has endometriosis?(2008)[TRIPAnswers]

In a young woman with endometriosis wanting to use depo provera for symptom control and contraception long term is there a way of minimising/negating bone loss?(2008)[TRIPAnswers]

Is there any evidence for the use of mirena coil in treatment of endometriosis?(2008)[TRIPAnswers]

After a woman has had a six month course of GnRH analogues for endometriosis, on average how long will it take for her periods to restart?(2008)[ATTRACT]

Patient Information

Endometriosis(2013)[NHS Choices] updated

Endometriosis(2013)[BUPA]

Endometriosis(2013) [Patient UK]

Important


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

Tuesday 27 January 2015

Clostridium difficile

Evidence Based Reports

A high-dose preparation of lactobacilli and bifidobacteria in the prevention of antibiotic-associated and Clostridium difficile diarrhoea in older people admitted to hospital: a multicentre, randomised, double-blind, placebo-controlled, parallel arm trial (PLACIDE)(2014)[NHS EED] NEW

Fecal Bacteriotherapy for Adult Patients with Recurrent Clostridium difficile infection: Update of Clinical and Cost-Effectiveness, and Guidelines (2014)[HTA database] NEW

Probiotics for Antibiotic-Associated Diarrhea, Clostridium difficile Infection and Irritable Bowel Syndrome: A Review of Clinical Evidence and Safety (2014)[HTA database] NEW

Fecal microbiota transplantation for Clostridium difficile infection: systematic review and meta-analysis. (2013) [DARE]

Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection. (2013) [DARE]

Clostridium difficile infection: fidaxomicin (2012) [NICE] NEW

Fidaxomicin for clostridium difficile-associated diarrhoea: epidemiological method for estimation of warranted price (2012) [NHS EED]

Is primary prevention of Clostridium difficile infection possible with specific probiotics? (2012) [DARE]

Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. (2012) [DARE] NEW

The potential economic value of screening hospital admissions for Clostridium difficile. (2012) [NHS EED]

Association between proton pump inhibitor therapy and Clostridium difficile infection in a meta-analysis. (2012) [DARE]

Comparative effectiveness of Clostridium difficile treatments: a systematic review. (2012) [DARE]

Fidaxomicin (Dificlir)- treatment of adults with clostridium difficile. (2012) [Scottish Medicines Consortium]

Antibiotic treatment for Clostridium difficile-associated diarrhea in adults (2011)[Cochrane Library]

Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults--a meta-analysis. (2011)[DARE]

Prevention of Clostridium difficile infection with Saccharomyces boulardii: a systematic review (2009)[DARE]

Clinical Guidelines

Faecal microbiota transplant for recurrent Clostridium difficile infection (2014)[NICE interventional procedure guidance] NEW

Clostridium difficile infection: how to deal with the problem (2009) [DoH]

Recent articles in core journals

Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection (2014)[JAMA] NEW

Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older inpatients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial. (2013) [Lancet]

Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study. (2012) [BMJ]

Using a dog's superior olfactory sensitivity to identify Clostridium difficile in stools and patients: proof of principle study. (2012) [BMJ]

Vancomycin or Metronidazole for Treatment of Clostridium difficile Infection: Clinical and Economic Analyses. (2011) [EvidenceUpdates]

Host and pathogen factors for Clostridium difficile infection and colonization. (2011) [NEJM]

Prevention of endemic healthcare-associated Clostridium difficile infection: reviewing the evidence.(2010)[EvidenceUpdates]

Clostridium difficile infection in Europe: a hospital-based survey. (2010)[Lancet]

In the clinic. Clostridium difficile Infection. (2010)[Annals of Internal Medicine]

Reducing Clostridium difficile infection in acute care by using an improvement collaborative. (2010)[BMJ]

Proton pump inhibitors and risk for recurrent Clostridium difficile infection. (2010)[EvidenceUpdates]

Treatment with monoclonal antibodies against Clostridium difficile toxins. (2010)[NEJM]

Does my patient have Clostridium difficile infection? (2009)[Annals of Internal Medicine]

Prospective derivation and validation of a clinical prediction rule for recurrent Clostridium difficile infection.(2009)[EvidenceUpdates]

A 76-year-old man with recurrent Clostridium difficile-associated diarrhea: review of C. difficile infection. (2009)[JAMA]

eTextbooks

Clostridium Difficile Colitis (2014)[eMedicine] updated

Clinical Queries

What is the evidence for the link between proton pump inhibitor usage and the development of Clostridium Difficile infection? (2008) [TRIPanswers]

Is there any evidence to link antibiotic prescribing in primary care with cases of clostridium difficile in the community setting? (2007) [TRIPanswers]

How long does clostridium difficile toxin remain positive in stool sample after treatment? (2007) [TRIPanswers]

Should people with hospital acquired clostridium difficile have their PPI withheld to help prevent recurrence? (2006) [TRIPanswers]

Patient Information

Clostridium difficile (2014)[BUPA] updated

Clostridium difficile (2014)[NHS Choices] updated

Clostridium Difficile (2012)[Patient UK]

Important

1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

Monday 19 January 2015

Helicobacter Pylori

Evidence Based Reports

Cost-effectiveness of the carbon-13 urea breath test for the detection of Helicobacter pylori: an economic analysis (2014)[NHS EED] NEW

Eradication of Helicobacter pylori for non-ulcer dyspepsia (2011) [Cochrane Library]

Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients. (2011) [Cochrane Library]

Helicobacter pylori eradication for Parkinson's disease. (2011)[Cochrane Library]

Usefulness of urea breath test for helicobacter pylori detection (2011)[HTA]

Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients (2011)[Cochrane Library]

Is there an increased risk of GERD after Helicobacter pylori eradication? A meta-analysis (2010)[DARE]

Empiric quadruple vs triple therapy for primary treatment of Helicobacter pylori infection: systematic review and meta-analysis of efficacy and tolerability (2010)[DARE]

Meta-analysis: four-drug, three-antibiotic, non-bismuth-containing "concomitant therapy" versus triple therapy for Helicobacter pylori eradication (2010)[DARE]

Helicobacter pylori infection (2009)[Clinical Evidence] subcription required

Sequential therapy or triple therapy for Helicobacter pylori infection: systematic review and meta-analysis of randomized controlled trials in adults and children (2009)[DARE]

Meta-analysis: Lactobacillus containing quadruple therapy versus standard triple first-line therapy for Helicobacter pylori eradication (2009)[DARE]

Moxifloxacin-based triple therapy versus clarithromycin-based triple therapy for first-line treatment of Helicobacter pylori infection: a meta-analysis of randomized controlled trials (2009)[DARE]

A systematic review of treating Helicobacter pylori infection with traditional Chinese medicine (2009)[DARE]

Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials (2009)[DARE]

Adverse events with bismuth salts for Helicobacter pylori eradication: systematic review and meta-analysis (2008)[DARE]

Clinical Guidelines


Recent articles in core journals

Ten day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment for Helicobacter pylori in Chinese patients: an open label, randomised, crossover trial (2014)[EvidenceUpdates] NEW

Risk of recurrent Helicobacter pylori infection 1 year after initial eradication therapy in 7 Latin American communities. (2013) [JAMA]

Randomised clinical trial comparing sequential and concomitant therapies for Helicobacter pylori eradication in routine clinical practice. (2013) [EvidenceUpdates]

Optimized nonbismuth quadruple therapies cure most patients with Helicobacter pylori infection in populations with high rates of antibiotic resistance. (2013) [EvidenceUpdates]

Sequential versus triple therapy for the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. (2013) [Lancet]

Helicobacter pylori eradication in functional dyspepsia: HEROES trial (2012) [EvidenceUpdates]

14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial.(2011)[Lancet]

Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. (2011)[Lancet]

Empirical levofloxacin-containing versus clarithromycin-containing sequential therapy for Helicobacter pylori eradication: a randomised trial.(2011)[EvidenceUpdates]

Comparison of the once-daily levofloxacin-containing triple therapy with the twice-daily standard triple therapy for first-line Helicobacter pylori eradication: a prospective randomised study. (2010)[EvidenceUpdates]

Levofloxacin-based and clarithromycin-based triple therapies as first-line and second-line treatments for Helicobacter pylori infection: a randomised comparative trial with crossover design. (2010)[EvidenceUpdates]

Association between helicobacter pylori and gastrointestinal symptoms in children. (2010)[EvidenceUpdates]

Empiric quadruple vs. triple therapy for primary treatment of Helicobacter pylori infection: Systematic review and meta-analysis of efficacy and tolerability. (2010)[EvidenceUpdates]

Sequential therapy or triple therapy for Helicobacter pylori infection: systematic review and meta-analysis of randomized controlled trials in adults and children. (2010)[EvidenceUpdates]

Meta-analysis: can Helicobacter pylori eradication treatment reduce the risk for gastric cancer? (2009)[Annals of Internal Medicine]

Meta-analysis: efficacy of bovine lactoferrin in Helicobacter pylori eradication. (2009)[EvidenceUpdates]

Duplicate breath testing to confirm eradication of Helicobacter pylori: incremental benefit and cost in 419 patients. (2009)[EvidenceUpdates]

eTextbooks

Helicobacter Pylori Infection (2014)[eMedicine] updated

Helicobacter Pylori (2014)[Mentor] updated

quadruple therapy for Helicobacter pylori eradication (2014)[GPnotebook] updated

Helicobacter pylori(2010)[GPnotebook]

Clinical Queries

Is there any evidence for treating helicobacter pylori in an otherwise well patient with no symptoms? (2012) [ATTRACT]

Is it possible to pass Helicobacter pylori person-to-person? (2009)[TRIPAnswers]

Is there a relation between H pylori infection and rosacea? Would H pylori eradication help management? (2009)[ATTRACT]

Patient Information

Helicobacter Pylori & Stomach Pain (2014)[PatientUK] updated

Helicobacter pylori (2009)[GPnotebook]

Important


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

Parkinson's disease

Evidence Based Reports

Physiotherapy for Parkinson’s disease: a comparison of techniques (2014)[Cochrane Library] NEW

Creatine for Parkinson’s disease (2014)[Cochrane Library] NEW

Specialist rehabilitation for people with Parkinson s disease in the community: a randomised controlled trial (2014)[NIHR HTA] NEW

Pimavanserin tartrate for psychosis associated with Parkinson’s disease - first line (2014)[HTA Database] NEW

Physiotherapy versus placebo or no intervention in Parkinson’s disease (2013) [Cochrane Library]

Cost-effectiveness of rasagiline compared with first-line early Parkinson disease therapies. (2013) [NHS EED]

Speech and language therapy versus placebo or no intervention for speech problems in Parkinson’s disease. (2012) [Cochrane Library]

Physiotherapy versus placebo or no intervention in Parkinson’s disease. (2012) [Cochrane Library]

Comparison of speech and language therapy techniques for speech problems in Parkinson’s disease. (2012) [Cochrane Library]

Anti-hypertensive drugs as disease-modifying agents for Parkinson’s disease: evidence from observational studies and clinical trials (2011)[Cochrane Library]

Helicobacter pylori eradication for Parkinson's disease (2011)[Cochrane Library]

Non-steroidal anti-inflammatory drugs as disease-modifying agents for Parkinson's disease: evidence from observational studies (2011)[Cochrane Library]

Treadmill training for patients with Parkinson’s disease (2010)[Cochrane Library]

Dopamine agonists in the treatment of early Parkinson's disease: a meta-analysis (2010)[DARE]

Anti-inflammatory drugs and risk of Parkinson disease: a meta-analysis (2010) [DARE]

Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease (2009)[Cochrane Library]

Dopamine agonist therapy in early Parkinson's disease (2008)[Cochrane Library]

Parkinson's disease (2007)[Clinical Evidence] subcription required

Clinical Guidelines

Parkinson's disease (2014)[CKS] updated

Diagnosis and pharmacological management of Parkinson’s disease (2010)[SIGN]

Parkinson's disease: diagnosis and management in primary and secondary care (2007) [NICE]

Recent articles in core journals

Pharmacological treatment of Parkinson disease: a review (2014)[EvidenceUpdates] NEW

Cholinesterase inhibitors for Parkinson's disease: a systematic review and meta-analysis (2014)[EvidenceUpdates] NEW

Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial (2014)[Lancet] NEW

Pimavanserin for patients with Parkinson's disease psychosis: a randomised, placebo-controlled phase 3 trial (2014)[Lancet] NEW

Improving functional disability and cognition in Parkinson disease: randomized controlled trial (2014)[EvidenceUpdates] Randomized trial of cognitive speed of processing training in Parkinson disease. (2013) [EvidenceUpdates]

The CamPaIGN study of Parkinson's disease: 10-year outlook in an incident population-based cohort. (2013) [EvidenceUpdates]

Supplementary motor area stimulation for Parkinson disease: a randomized controlled study. (2013) [EvidenceUpdates]

Promotion of physical activity and fitness in sedentary patients with Parkinson's disease: randomised controlled trial. (2013) [BMJ]

Caffeine for treatment of Parkinson disease: a randomized controlled trial. (2013) [EvidenceUpdates]

Extended-release pramipexole in early Parkinson disease: a 33-week randomized controlled trial. (2011)[EvidenceUpdates]

Rehabilitation with mental practice has similar effects on mobility as rehabilitation with relaxation in people with Parkinson's disease: a multicentre randomised trial (2011)[EvidenceUpdates]

Effects of whole-body vibration on sensorimotor performance in people with Parkinson disease: a systematic review (2011)[EvidenceUpdates]

Intermittent theta-burst transcranial magnetic stimulation for treatment of Parkinson disease (2011)[EvidenceUpdates]

Imputation of sequence variants for identification of genetic risks for Parkinson's disease: a meta-analysis of genome-wide association studies (2011)[Lancet]

Transcranial direct current stimulation for the treatment of Parkinson`s disease (2010)[Evidenceupdates]

Pramipexole for the treatment of depressive symptoms in patients with Parkinson`s disease: a randomised, double-blind, placebo-controlled trial (2010)[Lancet]

Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial (2009) [JAMA]

eTextbooks

Stereotactic Surgery in Parkinson Disease. (2014) [eMedicine] updated

Parkinson's disease (2014) [eMedicine] updated

Parkinsonism and Parkinson's Disease (2013)[Mentor]

Clinical Queries

A patient with Parkinsons on stalevo and ropinarole was given viagra for ED and felt it worsened his Parkinsons. Is this likely and is there evidence of a possible mechanism-eg drug interaction? (2010)[ATTRACT]

Is there evidence to support the use of nicotine patches for Parkinsons patients? (2008)[TRIPAnswers]

What is the evidence for statins causing Parkinsons disease? (2007)[TRIP answers]

I have a female patient both of whose parents have developed Parkinson's Disease in their 60's. What is the likelihood of her or her children developing parkinson's. Is there a genetic component? (2006) [TRIP answers]

I have a patient with early parkinsons disease and debilitating sialorrhoea. What is the best treatment for him? (2006)[TRIP answers]

Patient Information

Parkinson's Disease (2013)[PatientUK]

Parkinson's disease (2013)[BUPA]

Parkinson's disease (2013)[NHS Choices]

Important


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.

2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.Evaluation of the efficacy and safety of adjuvant treatment to levodopa therapy in Parkinson´s disease patients with motor complications (2010)[Cochrane]

Tuesday 13 January 2015

Hay fever

Evidence Based Reports

Omalizumab for the treatment of inadequately controlled allergic rhinitis: a systematic review and meta-analysis of randomized clinical trials (2014)[DARE] NEW

A systematic review and economic evaluation of subcutaneous and sublingual allergen immunotherapy in adults and children with seasonal allergic rhinitis. (2013) [HTA]

Helminth therapy (worms) for allergic rhinitis. (2012) [Cochrane Library]

Sublingual immunotherapy for allergic rhinitis (2010)[Cochrane Library]

Inferior turbinate surgery for nasal obstruction in allergic rhinitis after failed medical treatment (2010)[Cochrane Library]

Antihistamines used in addition to topical nasal steroids for intermittent and persistent allergic rhinitis in children(2010)[Cochrane Library]

Capsaicin for allergic rhinitis in adults (2010)[Cochrane Library]

Economic evaluation of quality-of-life improvement with second-generation antihistamines and montelukast in patients with allergic rhinitis (2009)[NHS Economic Evaluation Database]

Hay fever in adolescents and adults (2009)[Clinical Evidence] subscription required

Clinical Guidelines

Allergic rhinitis (2014) [CKS] updated

BSACI guidelines for the management of allergic and non-allergic rhinitis (2008)[National Library of Guidelines (UK]

Recent articles in core journals

Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis. (2011) [Evidence Updates]

Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis. (2008)[EvidenceUpdates]

Intranasal noninhaled carbon dioxide for the symptomatic treatment of seasonal allergic rhinitis (2008)[EvidenceUpdates]

Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial (2008)[EvidenceUpdates]

Effect of once-daily fluticasone furoate nasal spray on nasal symptoms in adults and adolescents with perennial allergic rhinitis (2008)[EvidenceUpdates]

Herbal medicines for the treatment of allergic rhinitis: a systematic review. (2008)[EvidenceUpdates]

eTextbooks

Allergic rhinitis (2014)[eMedicine] updated

Pediatric Allergic Rhinitis (2014)[eMedicine] updated

Allergic rhinitis (2012)[Mentor]

Clinical Queries

Which medicines can be used to treat intermittent allergic rhinitis during pregnancy? (2014)[UKMI] NEW

What is the role of Kenalog in the management of allergic rhinitis resistant to treatment? How often can it be repeated? (2013) [ATTRACT]

Is there any evidence that phototherapy nasal devices work in allergic rhinitis/ hay fever? (2009)[ATTRACT]

I have a 39 year old patient in the second trimester of her pregnancy. She has terrible hayfever and wants to use a non sedating antihistamine. Is loratadine safe? (2009)[ATTRACT]

How effective is butterbur for hayfever? What dose is recomended? Are there any interactions or side effects? (2009)[TRIPAnswers]

What is the current thinking on the use of the depot Kenalog in moderately severe hay fever not controlled by oral antihistamines and topical therapies? (2008)[ATTRACT]

What is the current clinical guidelines on the use of steroid injections for management of seasonal allergic rhinitis in UK? (2008)[TRIPAnswers]

What evidence is there of immunotherapy in patients with uncontrolled allergic rhinitis? (2008)[TRIPAnswers]

Patient Information

Seasonal allergic rhinits (2009)[NHS Choices] updated

Hay fever (seasonal allergic rhinitis) (2013) [BUPA]

Hayfever (2012) [PatientUK]

Important


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

Monday 12 January 2015

Falls

Evidence Based Reports

Oral Nutrition Intake for the Prevention of Falls in Older Adults: Clinical Effectiveness and Guidelines (2014)[HTA database] NEW

Fall Risk Assessment in Adult Patients: Comparative Evidence and Guidelines (2014)[HTA database] NEW

Fall Prevention Strategies for Adults in Outpatient Programs: Clinical Evidence and Guidelines (2014)[HTA database] NEW

Preventing falls in the community (2014)[HTA database] NEW

Preventing falls in hospitals (2014)[HTA database] NEW

Effectiveness of interventions for the assessment and prevention of falls in adult psychiatric patients: a systematic review (2014)[DARE] NEW

The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. (2013) [DARE]

Cost-utility analysis of a shock-absorbing floor intervention to prevent injuries from falls in hospital wards for older people (2013) [NHS EED]

Cost effectiveness of patient education for the prevention of falls in hospital: economic evaluation from a randomized controlled trial. (2013) [NHS EED]

Discriminative ability and predictive validity of the timed up and go test in identifying older people who fall: systematic review and meta-analysis. (2013) [DARE]

Inpatient fall prevention programs as a patient safety strategy: a systematic review. (2013) [DARE]

Meta-analysis: multidisciplinary fall prevention strategies in the acute care inpatient population. (2012) [DARE]

Interventions for preventing falls in older people living in the community. (2012) [Cochrane Library]

Some interventions are effective for preventing falls in older people (2011)[Cochrane Pearls]

Interventions for preventing falls in older people in care facilities and hospitals (2010)[Cochrane Library]

Vision improvement and reduction in falls after expedited cataract surgery: systematic review and metaanalysis (2010)[DARE]

Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults (2010)[NHS EED]

Systematic review of accuracy of screening instruments for predicting fall risk among independently living older adults (2010)[DARE]

Cost-effectiveness analysis of screening for risk of in-hospital falls using physiotherapist clinical judgement (2010)[NHS EED]

Interventions for preventing falls in older people living in the community (2009)[Cochrane Library]

NSAIDs and the risk of accidental falls in the elderly: a systematic review (2009)[DARE]

Quality of life as an outcome of fall prevention interventions among the aged: a systematic review (2009)[DARE]

Clinical Guidelines

Falls - Risk assessment (2014)[CKS] updated

Falls: assessment and prevention of falls in older people. (2013) [NICE]

Clinical practice guideline for the assessment and prevention of falls in older people. (2007) [RCN]

Recent articles in core journals

Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults (2014)[EvidenceUpdates] NEW

Home modifications to reduce injuries from falls in the Home Injury Prevention Intervention (HIPI) study: a cluster-randomised controlled trial (2014)[EvidenceUpdates] NEW

Effects of Tai Chi on balance and fall prevention in Parkinson's disease: a randomized controlled trial (2014) [EvidenceUpdates] NEW

Effects of vertical and side-alternating vibration training on fall risk factors and bone turnover in older people at risk of falls (2014)[EvidenceUpdates] NEW

Cognitive motor interference for preventing falls in older adults: a systematic review and meta-analysis of randomised controlled trials (2014)[EvidenceUpdates] NEW

The impact of first- and second-eye cataract surgery on injurious falls that require hospitalisation: a whole-population study. (2013) [EvidenceUpdates]

Effects of medication reviews performed by a physician on treatment with fracture-preventing and fall-risk-increasing drugs in older adults with hip fracture-a randomized controlled study. (2013) [EvidenceUpdates]

Fall prevention in community-dwelling older adults. (2013) [JAMA]

Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. (2012) [BMJ]

Long-term effects of three multicomponent exercise interventions on physical performance and fall-related psychological outcomes in community-dwelling older adults: a randomized controlled trial. (2012) [EvidenceUpdates]

Fall risk six weeks from onset of stroke and the ability of the Prediction of Falls in Rehabilitation Settings Tool and motor function to predict falls. (2012) [EvidenceUpdates]

Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital: a randomized controlled trial.(2011)[EvidenceUpdates]

Dementia medications and risk of falls, syncope, and related adverse events: meta-analysis of randomized controlled trials.(2011)[EvidenceUpdates]

The effects of Tai Chi on fall prevention, fear of falling and balance in older people: a meta-analysis (2010)[EvidenceUpdates]

Community falls prevention for people who call an emergency ambulance after a fall: randomised controlled trial. (2010)[EvidenceUpdates]

Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial (2010)[EvidenceUpdates]

Fear of falling after hip fracture: a systematic review of measurement instruments, prevalence, interventions, and related factors (2010)[EvidenceUpdates]

Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis (2010)[EvidenceUpdates]

Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults (2010)[EvidenceUpdates]

The Winchester falls project: a randomised controlled trial of secondary prevention of falls in older people (2010)[EvidenceUpdates]

Chronic musculoskeletal pain and the occurrence of falls in an older population. (2010)[EvidenceUpdates]

Reducing risk of falling in older people discharged from hospital: a randomized controlled trial comparing seated exercises, weight-bearing exercises, and social visits (2009)[EvidenceUpdates]

A meta-analysis of fear of falling treatment programs for the elderly (2009)[EvidenceUpdates]

eTextbooks

Recurrent fall (2014)[Mentor] updated

Prevention of falls in the elderly (2014)[Mentor] updated

Clinical Queries

NICE have recently recommended Vitamin D supplement to reduce falls in the elderly. Does this guidance apply only to those in Nursing homes or to an age group? What is the evidence for this intervention? What is the NNT to prevent 1 adverse outcome? (2009)[ATTRACT]

With older patients with a history of falls and diagnosed with Benign Paroxysmal Positional Vertigo, what is the success rate of Epley Manoeuvre (also known as Canalith Repositioning Technique)? (CEBPA) (2008)[TRIPAnswers]

What is the incidence of vestibular deficit resulting in falls within the elderly and what evidence is there to support vestibular rehabilitation against pharmaceutical management? (2008)[TRIPAnswers]

Patient Information

Falls (2013)[NHS Choices]

Important


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

PCOS

Evidence Based Reports

Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome (2014)[Cochrane Library] NEW

Aromatase inhibitors for subfertile women with polycystic ovary syndrome (2014)[Cochrane Library] NEW

Does Metformin combined with Clomiphene Citrate improve fertility related outcomes in Clomiphene resistant women with PCOS: A systematic review (2014)[DARE] NEW

In vitro maturation in subfertile women with polycystic ovarian syndrome undergoing assisted reproduction. (2013) [Cochrane Library]

Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. (2013) [DARE]

Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. (2012) [Cochrane Library]

Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. (2012) [Cochrane Library]

Statins for women with polycystic ovary syndrome not actively trying to conceive (2011)[Cochrane Library]

Acupuncture for polycystic ovarian syndrome (2011)[Cochrane Library]

Chinese herbal medicine for subfertile women with polycystic ovarian syndrome (2010)[Cochrane Library]

PCOS (2009)[Clinical Evidence] subscription required

Clomiphene citrate, metformin or both as first-step approach in treating anovulatory infertility in patients with polycystic ovary syndrome (PCOS): a systematic review of head-to-head randomized controlled studies and meta-analysis (2009)[DARE]

Effect of preconceptional metformin on abortion risk in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials (2009)[DARE]

In vitro maturation in sub fertile women with polycystic ovarian syndrome undergoing assisted reproduction (2009)[Cochrane Library]

Aromatase inhibitors for infertility in polycystic ovary syndrome: the beginning or the end of a new era? (2009)[DARE]

The effects of Diane-35 and metformin in treatment of polycystic ovary syndrome: an updated systematic review (2008)[DARE]

Long versus short course treatment with Metformin and Clomiphene Citrate for ovulation induction in women with PCOS (2008)[Cochrane Library]

Clinical Guidelines

Long-term Consequences of Polycystic Ovary Syndrome (2014)[RCOG] NEW

Polycystic ovary syndrome (2013)[CKS]

Recent articles in core journals

Effects of metformin in women with polycystic ovary syndrome treated with gonadotrophins for in vitro fertilisation and intracytoplasmic sperm injection cycles: a systematic review and meta-analysis of randomised controlled trials. (2013) [EvidenceUpdates]

Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study.(2011)[BMJ]

Pregnancy outcomes in women with polycystic ovary syndrome: a metaanalysis.(2011)[EvidenceUpdates]

Laparoscopic ovarian diathermy vs clomiphene citrate plus metformin as second-line strategy for infertile anovulatory patients with polycystic ovary syndrome: a randomized controlled trial (2010)[EvidenceUpdates]

Use of Metformin in Polycystic Ovary Syndrome: A Meta-Analysis (2008)[EvidenceUpdates]

eTextbooks

Polycystic Ovarian Syndrome (2014)[eMedicine] updated

Polycystic Ovarian Syndrome (2013)[Mentor]

polycystic ovary syndrome (2010)[GPnotebook]

Clinical Queries

What effect does metformin have on obesity and the cardiovascular problems seen in women with polycystic ovary syndrome? (2014)[WUKMI] NEW

How effective is metformin compared to co-cyprindiol/oral contraceptive pill in women with polycystic ovary syndrome? (2014)[WUKMI] NEW

What effect does metformin have on hirsutism and acne in women with polycystic ovary syndrome? (2014)[WUKMI] NEW

What effect does metformin have on insulin resistance or the development of diabetes in women with polycystic ovary syndrome? (2014)[UKMI] NEW

Which contraceptive method provides suitable endometrial protection for women with polycystic ovary syndrome (PCOS) and does the method differ by age? (2014)[FSRH] NEW

Do anovulatory methods of contraception reduce or halt the development of cysts in polycystic ovary syndrome (PCOS)? Furthermore many women with PCOS have a high BMI, is this a contraindication to the use of combined hormonal contraception (CHC) and if so which is the next best contraceptive method to ensure a bleed? (2014)[FSRH] NEW

Is there any evidence which identifies which contraceptive method is most effective for managing androgenic symptoms, especially hirsutism, in women with polycystic ovary syndrome who are breastfeeding? (2013) [FSRH]

Is there any evidence which identifies which contraceptive method is most effective for managing androgenic symptoms, especially hirsutism, in women with polycystic ovary syndrome who need contraception? (2013) [FSRH]

How long can metformin be prescribed for a woman who has PCOS, had 3 children, does not wish for more and non diabetic? (2012) [ATTRACT]

In PCOS patients how effective is metformin in the treatment of prediabetes? (2012) [ATTRACT]

Do any of the newer diabetic drugs [gliptins etc] have a role in weight reduction in PCOS? Is there any experience of use and are they licensed? (2011)[ATTRACT]

Should we continue to moniter lipids/glucose in a woman with PCOS who has had TAH/BSO (2011)[ATTRACT]

Patient Information

Polycystic ovary syndrome (PCOS0 (2012)[BUPA] updated

Polycystic Ovary Syndrome (2013)[PatientUK]

Polycystic ovary syndrome (2013)[NHS Choices]


Important

1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

Thursday 8 January 2015

Alcohol abuse

Evidence Based Reports

Motivational interviewing for alcohol misuse in young adults (2014)[Cochrane Library] NEW

Anticonvulsants for alcohol dependence (2014)[Cochrane Library] NEW

Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users (2014)[Cochrane Library] NEW

Pharmacotherapy for Adults With Alcohol-Use Disorders in Outpatient Settings (2014)[HTA] NEW

Thiamine for prevention and treatment of Wernicke-Korsakoff Syndrome in people who abuse alcohol. (2013) [Cochrane Library]

Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. (2013) [DARE]

Meta-analysis of supplemental treatment for depressive and anxiety disorders in patients being treated for alcohol dependence. (2012) [DARE]

Acamprosate for alcohol dependence: a sex-specific meta-analysis based on individual patient data. (2012) [DARE]

Exercise and non-alcoholic fatty liver disease: a systematic review and meta-analysis. (2012) [DARE]

Alcohol misuse (2011)[Clinical Evidence] subscription required

Propylthiouracil for alcoholic liver disease (2011)[CochraneLibrary]

Benzodiazepines for alcohol withdrawal (2010)[Cochrane Library]

Acamprosate for alcohol dependence (2010)[Cochrane Library]

Anticonvulsants for alcohol withdrawal (2010)[Cochrane Library]

Gamma-hydroxybutyrate (GHB) for treatment of alcohol withdrawal and prevention of relapses (2010)[Cochrane Library]

Pharmacologic Interventions for Pregnant Women Enrolled in Alcohol Treatment (2010)[Cochrane Library]

Acupuncture for alcohol dependence: a systematic review (2010)[DARE]

Interventions for reducing adolescent alcohol abuse: a meta-analytic review (2010) [DARE]

Cost-effectiveness of screening for unhealthy alcohol use with %carbohydrate deficient transferrin: results from a literature-based decision analytic computer model (2010)[NHS EED]

The cost effectiveness of naltrexone added to cognitive-behavioral therapy in the treatment of alcohol dependence (2010)[NHS EED]

Clinical Guidelines

Nalmefene for reducing alcohol consumption in people with alcohol dependence (2014)[NICE Technology Appraisals] NEW

Alcohol dependence and harmful alcohol use quality standard (2011)[NICE]

Alcohol - problem drinking (2011)[CKS]

The management of harmful drinking and alcohol dependence in primary care (2009)[SIGN]

Recent articles in core journals

Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis (2014)[EvidenceUpdates] NEW

Web-based alcohol screening and brief intervention for university students: a randomized trial (2014)[JAMA] NEW

Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: a modelling study (2014)[EvidenceUpdates] NEW

Prednisolone with vs without pentoxifylline and survival of patients with severe alcoholic hepatitis: a randomized clinical trial. (2013) [JAMA]

Concurrent naltrexone and prolonged exposure therapy for patients with comorbid alcohol dependence and PTSD: a randomized clinical trial. (2013) [JAMA]

Influence of serum sodium on MELD-based survival prediction in alcoholic hepatitis.(2011)[EvidenceUpdates]

Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis: meta-analysis of individual patient data.(2011)[EvidenceUpdates]

Early liver transplantation for severe alcoholic hepatitis.(2011)[NEJM]

Glucocorticoids plus N-acetylcysteine in severe alcoholic hepatitis.(2011)[NEJM]

The spread of alcohol consumption behavior in a large social network. (2009)[Annals of Internal Medicine]

Effectiveness and cost-effectiveness of a stepped care intervention for alcohol use disorders in primary care: pilot study (2010)[EvidenceUpdates]

Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized controlled trial. (2010)[JAMA]

A double-blind, placebo-controlled trial combining sertraline and naltrexone for treating co-occurring depression and alcohol dependence (2010)[EvidenceUpdates]

Interventions for reducing adolescent alcohol abuse: a meta-analytic review (2010)[EvidenceUpdates]

eTextbooks

Alcoholism (2014)[eMedicine] updated

Alcoholic Fatty Liver (2014)[eMedicine] updated

Alcohol and Substance Abuse Evaluation (2014)[eMedicine] updated

Alcoholic Ketoacidosis (2014)[eMedicine] updated

Fetal Alcohol Syndrome (2013)[Mentor]

Alcohol Related Problems (2012)[Mentor]

Fetal Alcohol Syndrome (2012)[eMedicine]

Alcoholism and Alcohol Abuse - Management (2011) [Mentor]

Clinical Queries

What contraception can be used by a 39 year old woman who smokes between 20 and 40 cigarettes per day, has undergone a liver transplant as a result of alcoholic liver disease, and who is currently taking steroids and tacrolimus? (2013) [FSRH]

With patients with alcohol dependence, does acamprosate plus usual care compared to usual care (ITT analysis) reduce alcohol dependence, mortality or hospitalisation rates? (2009)[TRIPAnswers]

How useful is carbohydrate deficient transferrin (CDT) as a marker for alcohol abuse? what are its limitations? (2009)[TRIPAnswers]

Is it safe to prescribe oral antifungals for a fungal nail infection, to a gentleman who drinks excessive alcohol with a raised GGT( 107), but normal LFTs? (2008)[TRIPAnswers]

Patient Information

Alcohol misuse (2013)[NHS Choices]

Sensible Drinking (2013)[BUPA]

Alcohol Detoxification (2010)[Patient UK]

Important

1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

Wednesday 7 January 2015

Multiple Sclerosis

Evidence Based Reports

Delta-9-tetrahydrocannabinol/cannabidiol (Sativex) - for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (2014)[All Wales Medicines Strategy Group] NEW

A pilot randomised controlled trial of an internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue. (2013)[NHS EED]

Fampridine-SR - For the treatment of walking disability in multiple sclerosis. (2013) [MTRAC]

A systematic review of randomized, double-blind, placebo-controlled trials examining the clinical efficacy of vitamin D in multiple sclerosis. (2013) [DARE]

Cost-effectiveness of an adjustment group for people with multiple sclerosis and low mood: a randomized trial. (2013) [NHS EED]

Laquinimod for multiple sclerosis. (2013) [Cochrane Library]

Daclizumab for relapsing remitting multiple sclerosis. (2013) [Cochrane Library]

Sildenafil citrate for erectile dysfunction in patients with multiple sclerosis. (2012) [Cochrane Library]

Carnitine for fatigue in multiple sclerosis. (2012) [Cochrane Library]

Memory Rehabilitation for people with multiple sclerosis. (2012) [Cochrane Library]

Multiple Sclerosis. (2012) [Clinical Evidence] Subcription required

Laquinimod for multiple sclerosis (2012) [Cochrane Library]

Neuropsychological rehabilitation for multiple sclerosis (2011)[Cochrane Library]

Pharmacologic treatment for memory disorder in multiple sclerosis (2011)[Cochrane Library]

Natalizumab for relapsing remitting multiple sclerosis (2011)[Cochrane Library]

Multidisciplinary rehabilitation for adults with multiple sclerosis (2011)[Cochrane Library]

Hyperbaric oxygen therapy for multiple sclerosis (2011)[Cochrane Library]

Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis (2011)[Cochrane Library]

Vitamin D for the management of multiple sclerosis (2010)[Cochrane Library]

Statins for multiple sclerosis (2010)[Cochrane Library]

Glatiramer acetate for multiple sclerosis (2010)[Cochrane Library]

Carnitine for fatigue in multiple sclerosis (2010)[Cochrane Library]

Intravenous immunoglobulins for multiple sclerosis (2010)[Cochrane Library]

Therapeutic interventions in the treatment of people with multiple sclerosis with mobility problems: a literature review (2010)[DARE]

Anticholinergics for urinary symptoms in multiple sclerosis (2009)[Cochrane Library]

Oral versus Intravenous Steroids for Treatment of Relapses in Multiple Sclerosis
(2009)[Cochrane Library]

Interferon Beta for Primary Progressive Multiple Sclerosis (2009)[Cochrane Library]

Clinical Guidelines

Multiple sclerosis management of multiple sclerosis in primary and secondary care (2014)[NICE] NEW

Alemtuzumab for treating relapsing-remitting multiple sclerosis (2014)[NICE Technology Appraisals] NEW

Teriflunomide for treating relapsing–remitting multiple sclerosis (2014)[NICE Technology Appraisals] NEW

Dimethyl fumarate for treating relapsing-remitting multiple sclerosis (2014)[NICE Technology Appraisals] NEW

Recent articles in core journals

Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial (2014)[EvidenceUpdates] NEW

Pegylated interferon β-1a for relapsing-remitting multiple sclerosis (ADVANCE): a randomised, phase 3, double-blind study (2014)[EvidenceUpdates] NEW

Oral teriflunomide for patients with relapsing multiple sclerosis (TOWER): a randomised, double-blind, placebo-controlled, phase 3 trial (2014)[EvidenceUpdates]NEW

Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, phase 2 trial(2014)[EvidenceUpdates] NEW

Mulitiple Sclerosis and Extract of Cannabis: results of the MUSEC trial. (2013) [EvidenceUpdates]

Cell therapy for multiple sclerosis: an evolving concept with implications for other neurodegenerative diseases. (2013) [Lancet]

Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. (2013) [EvidenceUpdates]

Daclizumab high-yield process in relapsing-remitting multiple sclerosis (SELECT): a randomised, double-blind, placebo-controlled trial. (2013) [Lancet]

A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis. (2013) [EvidenceUpdates]

Massage therapy and exercise therapy in patients with multiple sclerosis: a randomized controlled pilot study. (2013) [EvidenceUpdates]

Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomised controlled phase 3 trial. (2012) [Lancet]

Relapse and disability outcomes in patients with multiple sclerosis treated with fingolimod: subgroup analyses of the double-blind, randomised, placebo-controlled FREEDOMS study. (2012) [EvidenceUpdates]

Inflammatory cortical demyelination in early multiple sclerosis.(2011)[NEJM]

Ocrelizumab in relapsing-remitting multiple sclerosis: a phase 2, randomised, placebo-controlled, multicentre trial. (2011)[Lancet]

Randomized trial of oral teriflunomide for relapsing multiple sclerosis.(2011)[NEJM]

A phase 3 trial of extended release oral dalfampridine in multiple sclerosis. (2010)[EvidenceUpdates]

Methylprednisolone in combination with interferon beta-1a for relapsing-remitting multiple sclerosis (MECOMBIN study): a multicentre, double-blind, randomised, placebo-controlled, parallel-group trial. (2010)[EvidenceUpdates]

A phase I/II dose-escalation trial of vitamin D3 and calcium in multiple sclerosis.(2010)[EvidenceUpdates]

Daclizumab in active relapsing multiple sclerosis (CHOICE study): a phase 2, randomised, double-blind, placebo-controlled, add-on trial with interferon beta. (2010)[EvidenceUpdates]

Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial. (2010)[EvidenceUpdates]

A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. (2010)[NEJM]

Resistance training improves muscle strength and functional capacity in multiple sclerosis. (2010)[EvidenceUpdates]

eTextbooks

Multiple Sclerosis (2014)[Mentor] updated

Brain Imaging in Multiple Sclerosis (2014)[eMedicine] updated

Multiple Sclerosis (2014)[eMedicine] updated

Multiple Sclerosis (2014)[GPnotebook] updated

Clinical Queries

Is there any evidence for the use of vitamin B12 supplements/oral or injection in the management of Multiple Sclerosis in the presence of normal vitamin B12 levels? Is there harm from over use of vitamin B12. (2011) [ATTRACT]

I have a patient who has Multiple sclerosis who is travelling to India. He will need to take chloroquine and proguanil as malaria prophylaxis. Are there any reported complications in MS with these medications? (2010)[ATTRACT]

Is there any evidence that atorvastatin alleviates symptoms, maintains remission or is useful in flare-ups of multiple sclerosis? (2009)[ATTRACT]

For women with multiple sclerosis can Depot medroxyprogesterone acetate be safely used? (2008)[Tripanswers]

Is there any evidence for the use of vitamin b12 for the treatment of fatigue in patients with multiple sclerosis? (2008)[TRIPAnswers]

What is the benefit of early diagnosis in Multiple Sclerosis; does early diagnosis and early intervention improve outcome in the longer term? (2008)[TRIPAnswers]

In a patient with multiple sclerosis, does oral treatment with a statin tablet (compared with no treatment) reduce the risk of symptoms, relapses or development of the disease? (2008)[TRIPAnswers]

Patient Information

Multiple Sclerosis. (2014) [NHS Choices] updated

Multiple Sclerosis (2014)[PatientUK] updated

Multiple sclerosis (2012)[BUPA]

Important


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.