Reviews

Combined and alternating paracetamol and ibuprofen therapy for febrile children
There is some evidence that both alternating and combined antipyretic therapy may be more effective at reducing temperatures than monotherapy alone. However, the evidence for improvements in measures of child discomfort remains inconclusive. There is insufficient evidence to know which of combined or alternating therapy might be more beneficial.Future research needs to measure child discomfort using standardized tools, and assess the safety of combined and alternating antipyretic therapy. Wong T, Stang AS, Ganshorn H, Hartling L, Maconochie IK, Thomsen AM, Johnson DW. Cochrane Database Syst Rev. 2013 Oct 30;10:CD009572. PMID: 24174375

Restrictive vs liberal transfusion for upper gastrointestinal bleeding: A meta-analysis of randomized controlled trials
Restrictive transfusion should be employed in patients with UGIB. Wang J, Bao YX, Bai M, Zhang YG, Xu WD, Qi XS. World J Gastroenterol. 2013 Oct 28;19(40):6919-27. PMID: 24187470

Effects of probiotics on nonalcoholic fatty liver disease: A meta-analysis
Probiotic therapies can reduce liver aminotransferases, total-cholesterol, TNF-α and improve insulin resistance in NAFLD patients. Modulation of the gut microbiota represents a new treatment for NAFLD. Ma YY, Li L, Yu CH, Shen Z, Chen LH, Li YM. World J Gastroenterol. 2013 Oct 28;19(40):6911-8. PMID: 24187469

Lifestyle interventions for acute gout
There is low quality evidence, from a single trial at high risk of bias, that the addition of topical ice therapy to oral prednisolone and colchicine for oligoarticular attacks of acute gout results in significantly greater pain reduction at one week. Moi JH, Sriranganathan MK, Edwards CJ, Buchbinder R. Cochrane Database Syst Rev. 2013 Nov 4;11:CD010519. [Epub ahead of print] PMID: 24186771

A systematic review of guidelines for the physical management of osteoarthritis
Exercise and education were key recommendations supporting the importance of rehabilitation in the role in the physical management of OA. This critical appraisal can assist health care providers who are involved in the management of people with OA. Larmer PJ, Reay ND, Aubert ER, Kersten P. Arch Phys Med Rehabil. 2013 Oct 31. [Epub ahead of print] PMID: 24184307

Antibiotics for sore throat
Antibiotics confer relative benefits in the treatment of sore throat. However, the absolute benefits are modest. Protecting sore throat sufferers against suppurative and non-suppurative complications in high-income countries requires treating many with antibiotics for one to benefit. This NNTB may be lower in low-income countries. Antibiotics shorten the duration of symptoms by about 16 hours overall. Spinks A, Glasziou PP, Del Mar CB. Cochrane Database Syst Rev. 2013 Nov 5;11:CD000023. [Epub ahead of print] PMID: 24190439

Hydration for treatment of preterm labour
The data are too few to support the use of hydration as a specific treatment for women presenting with preterm labour. The two small studies available do not show any advantage of hydration compared with bed rest alone. Intravenous hydration does not seem to be beneficial, even during the period of evaluation soon after admission, in women with preterm labour. Women with evidence of dehydration may, however, benefit from the intervention. Stan CM, Boulvain M, Pfister R, Hirsbrunner-Almagbaly P. Cochrane Database Syst Rev. 2013 Nov 4;11:CD003096. [Epub ahead of print] PMID: 24190310