Psychological therapies for the management of chronic and recurrent pain in children and adolescents.

Related Articles Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev. 2018 Sep 29;9:CD003968 Authors: Fisher E, Law E, Dudeney J, Palermo TM, Stewart G, Eccleston C Abstract BACKGROUND: This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and…

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Enteral nutrition for maintenance of remission in Crohn’s disease.

Related Articles Enteral nutrition for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2018 Aug 11;8:CD005984 Authors: Akobeng AK, Zhang D, Gordon M, MacDonald JK Abstract BACKGROUND: Prevention of relapse is a major issue in the management of quiescent Crohn’s disease (CD). Current therapies (e.g. methotrexate, biologics, 6-mercaptopurine and azathioprine) may be effective for maintaining remission in CD, but these drugs may cause significant adverse events. Interventions that are effective and safe for maintenance of remission in CD are desirable. OBJECTIVES: The primary objectives were to evaluate the…

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Natalizumab for induction of remission in Crohn’s disease.

Natalizumab for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2018 Aug 01;8:CD006097 Authors: Nelson SM, Nguyen TM, McDonald JW, MacDonald JK Abstract BACKGROUND: This systematic review update summarizes the current evidence on the use of natalizumab for induction of remission in Crohn’s disease (CD). OBJECTIVES: To determine the efficacy and safety of natalizumab for induction of remission in CD. SEARCH METHODS: We searched MEDLINE, Embase, CENTRAL, the Cochrane IBD Group Specialized Trials Register, and clinicaltrials.gov from inception to 10 May 2018. SELECTION CRITERIA: We included randomized controlled…

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Withdrawal of immunosuppressant or biologic therapy for patients with quiescent Crohn’s disease.

Withdrawal of immunosuppressant or biologic therapy for patients with quiescent Crohn’s disease. Cochrane Database Syst Rev. 2018 May 12;5:CD012540 Authors: Boyapati RK, Torres J, Palmela C, Parker CE, Silverberg OM, Upadhyaya SD, Nguyen TM, Colombel JF Abstract BACKGROUND: Crohn’s disease (CD) is a chronic, relapsing and remitting disease of the gastrointestinal tract that can cause significant morbidity and disability. Current treatment guidelines recommend early intervention with immunosuppressant or biological therapy in high-risk patients with a severe disease phenotype at presentation. The feasibility of therapeutic de-escalation once remission is achieved is…

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Low dose naltrexone for induction of remission in Crohn’s disease.

Low dose naltrexone for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2018 Apr 01;4:CD010410 Authors: Parker CE, Nguyen TM, Segal D, MacDonald JK, Chande N Abstract BACKGROUND: Crohn’s disease is a transmural, relapsing inflammatory condition afflicting the digestive tract. Opioid signalling, long known to affect secretion and motility in the gut, has been implicated in the inflammatory cascade of Crohn’s disease. Low dose naltrexone, an opioid antagonist, has garnered interest as a potential therapy. OBJECTIVES: The primary objective was to evaluate the efficacy and safety of low…

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Enteral nutritional therapy for induction of remission in Crohn’s disease.

Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2018 Apr 01;4:CD000542 Authors: Narula N, Dhillon A, Zhang D, Sherlock ME, Tondeur M, Zachos M Abstract BACKGROUND: Corticosteroids are often preferred over enteral nutrition (EN) as induction therapy for Crohn’s disease (CD). Prior meta-analyses suggest that corticosteroids are superior to EN for induction of remission in CD. Treatment failures in EN trials are often due to poor compliance, with dropouts frequently due to poor acceptance of a nasogastric tube and unpalatable formulations. This systematic review…

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Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis.

Related Articles Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis. Cochrane Database Syst Rev. 2018 Jan 16;1:CD011450 Authors: Mohammed Vashist N, Samaan M, Mosli MH, Parker CE, MacDonald JK, Nelson SA, Zou GY, Feagan BG, Khanna R, Jairath V Abstract BACKGROUND: Endoscopic assessment of mucosal disease activity is routinely used to determine eligibility and response to therapy in clinical trials of ulcerative colitis. The operating properties of the existing endoscopic scoring indices are unclear. OBJECTIVES: A systematic review was undertaken to evaluate the development and operating characteristics…

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Mesalamine (5-ASA) for the prevention of recurrent diverticulitis.

Mesalamine (5-ASA) for the prevention of recurrent diverticulitis. Cochrane Database Syst Rev. 2017 Oct 03;10:CD009839 Authors: Carter F, Alsayb M, Marshall JK, Yuan Y Abstract BACKGROUND: Diverticular disease is a common condition that increases in prevalence with age. Recent theories on the pathogenesis of diverticular inflammation have implicated chronic inflammation similar to that seen in ulcerative colitis. Mesalamine, or 5-aminosalicylic acid (5-ASA), is a mainstay of therapy for individuals with ulcerative colitis. Accordingly, 5-ASA has been studied for prevention of recurrent diverticulitis. OBJECTIVES: To evaluate the efficacy of mesalamine (5-ASA)…

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Strategies for detecting colon cancer in patients with inflammatory bowel disease.

Strategies for detecting colon cancer in patients with inflammatory bowel disease. Cochrane Database Syst Rev. 2017 Sep 18;9:CD000279 Authors: Bye WA, Nguyen TM, Parker CE, Jairath V, East JE Abstract BACKGROUND: Patients with longstanding ulcerative colitis and colonic Crohn’s disease have an increased risk of colorectal cancer (CRC) compared with the general population. This review assessed the evidence that endoscopic surveillance may prolong life by allowing earlier detection of CRC or its pre-cursor lesion, dysplasia, in patients with inflammatory bowel disease (IBD). OBJECTIVES: To assess the effectiveness of cancer surveillance…

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Placebo response and remission rates in randomised trials of induction and maintenance therapy for ulcerative colitis.

Placebo response and remission rates in randomised trials of induction and maintenance therapy for ulcerative colitis. Cochrane Database Syst Rev. 2017 Sep 08;9:CD011572 Authors: Jairath V, Zou GY, Parker CE, MacDonald JK, AlAmeel T, Al Beshir M, Almadi MA, Al-Taweel T, Atkinson NS, Biswas S, Chapman T, Dulai PS, Glaire MA, Hoekman DR, Koutsoumpas A, Minas E, Mosli MH, Samaan M, Khanna R, Travis S, D’Haens G, Sandborn WJ, Feagan BG Abstract BACKGROUND: It is important to minimize placebo rates in randomised controlled trials (RCTs) to efficiently detect treatment differences…

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