pinecone/core-2020-05-10-deduplication huggingface dataset:
Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth

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                  109646.pdf (publisher's version ) (Open Access)BACKGROUND: The prophylactic removal of asymptomatic impacted wisdom teeth is defined as the (surgical) removal of wisdom teeth in the absence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, gum and alveolar bone disease, damage to the adjacent teeth and the development of cysts and tumours. Other reasons to justify prophylactic removal have been to prevent late incisor crowding. When surgical removal is carried out in older patients, following the development of symptoms, the risk of postoperative complications, pain and discomfort increases. Nevertheless, in most developed countries prophylactic removal of trouble-free wisdom teeth, either impacted or fully erupted, has long been considered as 'appropriate care' and is a very common procedure. There is a need to determine whether there is evidence to support this practice. OBJECTIVES: To evaluate the effects of prophylactic removal of asymptomatic impacted wisdom teeth in adolescents and adults compared with the retention (conservative management) of these wisdom teeth. SEARCH METHODS: The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 30 March 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1950 to 30 March 2012), and EMBASE via OVID (1980 to 30 March 2012). There were no restrictions on language or date of publication. SELECTION CRITERIA: All randomised controlled trials (RCTs) on adolescents and adults comparing the effect of prophylactic removal of asymptomatic impacted wisdom teeth with no-treatment (retention). DATA COLLECTION AND ANALYSIS: Six review authors screened the results of the search and assessed whether trials met the inclusion criteria for the review. Data extraction and risk of bias assessment were conducted in duplicate and independently by six review authors. Where information was unclear, authors of studies were contacted for additional information. MAIN RESULTS: No RCTs were identified that compared the removal of asymptomatic wisdom teeth with retention and reported quality of life. One RCT on adolescents was identified that compared the removal of impacted mandibular wisdom teeth with retention and only examined the effect on late lower incisor crowding. This study at high risk of bias provided no evidence that extraction of wisdom teeth had an effect on lower incisor crowding over 5 years. AUTHORS' CONCLUSIONS: Insufficient evidence was found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults. A single trial comparing removal versus retention found no evidence of a difference on late lower incisor crowding at 5 years, however no other relevant outcomes were measured.Watchful monitoring of asymptomatic third molar teeth may be a more prudent strategy
Thymic peptides for treatment of cancer patients

Background\ud
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Purified thymus extracts (pTE) and synthetic thymic peptides (sTP) are thought to enhance the immune system of cancer patients in order to fight the growth of tumour cells and to resist infections due to immunosuppression induced by the disease and antineoplastic therapy.\ud
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Objectives\ud
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To evaluate the effectiveness of pTE and sTP for the management of cancer.\ud
Search methods\ud
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We searched CENTRAL (The Cochrane Library 2010, Issue 3), MEDLINE, EMBASE, AMED, BIOETHICSLINE, BIOSIS, CATLINE, CISCOM, HEALTHSTAR, HTA, SOMED and LILACS (to February 2010).\ud
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Selection criteria\ud
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Randomised trials of pTE or sTP in addition to chemotherapy or radiotherapy, or both, compared to the same regimen with placebo or no additional treatment in adult cancer patients.\ud
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Data collection and analysis\ud
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Two authors independently extracted data from published trials. We derived odds ratios (OR) from overall survival (OS) and disease-free survival (DFS) rates, tumour response (TR) rates, and rates of adverse effects (AE) related to antineoplastic treatments. We used a random-effects model for meta-analysis.\ud
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Main results\ud
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We identified 26 trials (2736 patients). Twenty trials investigated pTE (thymostimulin or thymosin fraction 5) and six trials investigated sTP (thymopentin or thymosin α1). Twenty-one trials reported results for OS, six for DFS, 14 for TR, nine for AE and 10  for safety of pTE and sTP. Addition of pTE conferred no benefit on OS (RR 1.00, 95% CI 0.79 to 1.25); DFS (RR 0.97, 95% CI 0.82 to 1.16); or TR (RR 1.07, 95% CI 0.92 to 1.25). Heterogeneity was moderate to high for all these outcomes. For thymosin α1 the pooled RR for OS was 1.21 (95% CI 0.94 to 1.56, P = 0.14), with low heterogeneity; and 3.37 (95% CI 0.66 to 17.30, P = 0.15) for DFS, with moderate heterogeneity. The pTE reduced the risk of severe infectious complications (RR 0.54, 95% CI 0.38 to 0.78, P = 0.0008; I² = 0%). The RR for severe neutropenia in patients treated with thymostimulin was 0.55 (95% CI 0.25 to 1.23,  P = 0.15). Tolerability of pTE and sTP was good. Most of the trials had at least a moderate risk of bias.\ud
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Authors' conclusions\ud
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Overall, we found neither evidence that the addition of pTE to antineoplastic treatment reduced the risk of death or disease progression nor that it improved the rate of tumour responses to antineoplastic treatment. For thymosin α1, there was a trend for a reduced risk of dying and of improved DFS. There was preliminary evidence that pTE lowered the risk of severe infectious complications in patients undergoing chemotherapy or radiotherapy
Individual patient education for low back pain.

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                  69744.pdf (publisher's version ) (Open Access)BACKGROUND: While many different types of patient education are widely used, the effect of individual patient education for low-back pain (LBP) has not yet been systematically reviewed. OBJECTIVES: To determine whether individual patient education is effective in the treatment of non-specific low-back pain and which type is most effective. SEARCH STRATEGY: A computerized literature search of MEDLINE (1966 to July 2006), EMBASE (1988 to July 2006), CINAHL (1982 to July 2006), PsycINFO (1984 to July 2006), and the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 2) was performed. References cited in the identified articles were screened. SELECTION CRITERIA: Studies were selected if the design was a randomised controlled trial; if patients experienced LBP; if the type of intervention concerned individual patient education, and if the publication was written in English, German, or Dutch. DATA COLLECTION AND ANALYSIS: The methodological quality was independently assessed by two review authors. Articles that met at least 50% of the quality criteria were considered high quality. Main outcome measures were pain intensity, global measure of improvement, back pain-specific functional status, return-to-work, and generic functional status. Analysis comprised a qualitative analysis. Evidence was classified as strong, moderate, limited, conflicting or no evidence. MAIN RESULTS: Of the 24 studies included in this review, 14 (58%) were of high quality. Individual patient education was compared with no intervention in 12 studies; with non-educational interventions in 11 studies; and with other individual educational interventions in eight studies. Results showed that for patients with subacute LBP, there is strong evidence that an individual 2.5 hour oral educational session is more effective on short-term and long-term return-to-work than no intervention. Educational interventions that were less intensive were not more effective than no intervention. Furthermore, there is strong evidence that individual education for patients with (sub)acute LBP is as effective as non-educational interventions on long-term pain and global improvement and that for chronic patients, individual education is less effective for back pain-specific function when compared to more intensive interventions. Comparison of different types of individual education did not show significant differences. AUTHORS' CONCLUSIONS: For patients with acute or subacute LBP, intensive patient education seems to be effective. For patients with chronic LBP, the effectiveness of individual education is still unclear
Dietary advice for treatment of type 2 diabetes mellitus in adults

Background: While initial dietary management immediately after formal diagnosis is an ’accepted’ cornerstone of treatment of type 2 diabetes mellitus, a formal and systematic overview of its efficacy and method of delivery is not currently available.\ud
Objectives: To assess the effects of type and frequency of different types of dietary advice for adults with type 2 diabetes.\ud
Search strategy: We carried out a comprehensive search of The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, bibliographies and contacted relevant experts.\ud
Selection criteria: All randomised controlled trials, of six months or longer, in which dietary advice was the main intervention.\ud
Data collection and analysis: The lead investigator performed all data extraction and quality scoring with duplication being carried out by one of the other six investigators independently with discrepancies resolved by discussion and consensus. Authors were contacted for missing data.\ud
Main results: Thirty-six articles reporting a total of eighteen trials following 1467 participants were included. Dietary approaches assessed in this review were low-fat/high-carbohydrate diets, high-fat/low-carbohydrate diets, low-calorie (1000 kcal per day) and very-low-calorie (500 kcal per day) diets and modified fat diets. Two trials compared the American Diabetes Association exchange diet with a standard reduced fat diet and five studies assessed low-fat diets versus moderate fat or low-carbohydrate diets. Two studies assessed the effect of a very-low-calorie diet versus a low-calorie diet. Six studies compared dietary advice with dietary advice plus exercise and three other studies assessed dietary advice versus dietary advice plus behavioural approaches. The studies all measured weight and measures of glycaemic\ud
control although not all studies reported these in the articles published. Other outcomes which were measured in these studies included\ud
mortality, blood pressure, serum cholesterol (including LDL and HDL cholesterol), serum triglycerides, maximal exercise capacity and\ud
compliance. The results suggest that adoption of regular exercise is a good way to promote better glycaemic control in type 2 diabetic\ud
patients, however all of these studies were at high risk of bias
Psychological interventions for symptomatic management of non-specific  chest pain in patients with normal coronary anatomy

Background  Recurrent chest pain in the absence of coronary artery disease is a common problem that sometimes leads to excess use of medical care.  Although many studies examine the causes of pain in these patients, few clinical trials have evaluated treatment. The studies reviewed  in this paper provide an insight into the effectiveness of psychological interventions for this group of patients.  Objectives  To investigate psychological treatments for non-specific chest pain (NSCP) with normal coronary anatomy.  Search strategy  We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2008, Issue 4), MEDLINE (1966 to December 2008),  CINAHL (1982 to December 2008) EMBASE (1980 to December 2008), PsycINFO (1887 to December 2008), the Database of  Abstracts of Reviews of Effectiveness (DARE) and Biological Abstracts (January 1980 to December 2008). We also searched citation  lists and approached authors.  Selection criteria  Randomised controlled trials (RCTs) with standardised outcome methodology that tested any form of psychotherapy for chest pain  with normal anatomy. Diagnoses included non-specific chest pain, atypical chest pain, syndrome X, or chest pain with normal coronary  anatomy (as either inpatients or outpatients).  Data collection and analysis  Two authors independently selected studies for inclusion, extracted data and assessed quality of studies. The authors contacted trial  authors for further information about the RCTs included.Full Tex
Psychosocial combined with agonist maintenance treatments versus agonist maintenance treatments alone for treatment of opioid dependence.

Objective:\ud
To evaluate the effectiveness of any psychosocial plus any agonist maintenance treatment versus standard agonist treatment for opiate dependence in respect of retention in treatment, use of substances, health and social status.\ud
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The abuse of opioid drugs and drug dependency are major health and social issues. Maintenance treatments with pharmacological agents can help to reduce the risks associated with the use of street drugs for drug addicts who are unable to abstain from drug use. Methadone is effective in retaining patients in treatment and reducing heroin use but re-addiction remains as a substantial challenge. Opiate addicts often have psychiatric problems such as anxiety and depression and may not be able to cope with stress. Psychosocial interventions including psychiatric care, psychotherapy, counselling, and social work services are commonly offered as part of the maintenance programs. Psychological support varies from structured psychotherapies such as cognitive behavioural therapy and supportive-expressive therapy to behavioural interventions and contingency management. \ud
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This review addressed whether a specific psychosocial intervention provides any additional benefit to pharmacological maintenance treatment. The control intervention was a maintenance program, which routinely offers counselling sessions in addition to pharmacological treatment. Present evidence suggests that adding psychosocial support does not change the effectiveness of retention in treatment and opiate use during treatment. Findings on retention in treatment were for 12 different psychosocial interventions including contingency management. These conclusions are based on 34 randomised trials involving 3777 opiate addicts, some 73% of whom were male. All but three studies were conducted in the USA. \ud
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The previous version of this review showed a reduction in opiate use during treatment that was no longer the case with the addition of new studies and the same is for the number of participants abstinent at the end of follow up. The psychosocial interventions are likely to require rigorous assessment of any changes in emotional, interpersonal, vocational and physical health areas of life functioning that may indirectly reduce drug use over longer periods of time
Surgical versus non-surgical treatment for acute anterior shoulder dislocation

Background: Acute anterior dislocation is the commonest type of shoulder dislocation. Subsequently, the shoulder is less stable and more susceptible to redislocation, especially in active young adults. \ud
Objectives: To compare surgical versus non-surgical treatment for acute anterior dislocation of the shoulder.\ud
Search strategy: The authors searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (14 August 2009), The Cochrane Library (2009, Issue 3), MEDLINE (1950 to August 2009), EMBASE (1980 to August 2009), trial registration databases, conference proceedings and reference lists of articles.\ud
Selection criteria: Randomised or quasi-randomised controlled trials comparing surgical with conservative interventions.\ud
Data collection and analysis: Both authors independently selected trials, assessed methodological quality and extracted data. Where appropriate, results were pooled.\ud
Main results: The four included studies involved 163 participants, mainly active young adult males. All had had a primary (first time) traumatic anterior shoulder dislocation. Methodological quality was variable.\ud
All participants of one trial returned to active military duty. Two trials respectively reported similar numbers with reduced sports participation or non return to previous activities. The other, an inadequately reported, trial found significantly fewer people in the surgical group failed to attain previous levels of sports activity.\ud
Pooled results from all four trials showed that subsequent instability, either redislocation or subluxation, was statistically significantly less frequent in the surgical group (risk ratio 0.25, 95% confidence interval 0.14 to 0.44). This result remained statistically significant (risk ratio 0.32, 95% confidence interval 0.17 to 0.59) for the three trials reported in full. Half (17/33) of the conservatively treated patients with shoulder instability in these three trials opted for subsequent surgery.\ud
Different, mainly patient rated, functional assessment measures for the shoulder were recorded in these trials. The results were more favourable, usually statistically significantly so, in those treated surgically.\ud
The only complication reported was a septic joint in a surgically treated patient. There was no information on shoulder pain, long-term complications or resource use.\ud
Authors' conclusions: Limited evidence supports primary surgery for young adults, usually male, engaged in highly demanding physical activities who have sustained their first acute traumatic shoulder dislocation. There is no evidence available to determine which treatment is better for other patient groups.\ud
Sufficiently powered, good quality, well reported randomised trials are required that compare surgical treatment with conservative treatment for these injuries, including in people at lower risk of recurrence. Long-term surveillance of outcome, looking at shoulder disorders including osteoarthritis is also required
School-based education programmes for the prevention of child sexual abuse

Background \ud
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Child sexual abuse is a significant global problem in both magnitude and sequelae. The most widely used primary prevention strategy has been the provision of school-based education programmes. Although programmes have been taught in schools since the 1980s, their effectiveness requires ongoing scrutiny. \ud
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Objectives \ud
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To systematically assess evidence of the effectiveness of school-based education programmes for the prevention of child sexual abuse. Specifically, to assess whether: programmes are effective in improving students’ protective behaviours and knowledge about sexual abuse prevention; behaviours and skills are retained over time; and participation results in disclosures of sexual abuse, produces harms, or both. \ud
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Search methods \ud
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In September 2014, we searched CENTRAL, OvidMEDLINE, EMBASE and 11 other databases.We also searched two trials registers and screened the reference lists of previous reviews for additional trials. \ud
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Selection criteria \ud
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We selected randomised controlled trials (RCTs), cluster-RCTs, and quasi-RCTs of school-based education interventions for the prevention of child sexual abuse compared with another intervention or no intervention. \ud
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Data collection and analysis \ud
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Two review authors independently assessed the eligibility of trials for inclusion, extracted data, and assessed risk of bias.We summarised data for six outcomes: protective behaviours; knowledge of sexual abuse or sexual abuse prevention concepts; retention of protective behaviours over time; retention of knowledge over time; harm; and disclosures of sexual abuse. School
Low glycaemic index diets for coronary heart disease

Background: The glycaemic index (GI) is a physiological measure of the ability of a carbohydrate to affect blood glucose. Interest is growing in the low GI carbohydrate concept for the clinical management of people at risk of, or with established coronary heart disease. There is a need to review the current evidence from randomised controlled trials (RCTs) in this area.\ud
Objectives: To review evidence from RCTs assessing the relationship between the consumption of low GI diets and the effects on coronary heart disease (CHD) and related risk factors in people who have established CHD or risk factors.\ud
Search strategy: We searched CENTRAL on The Cochrane Library (Issue 2, 2006), MEDLINE (1966 to July 2006), EMBASE (1980 to July 2006) and CINAHL (1982 to July 2006). We checked references and contacted experts in the field. No language restrictions were applied.\ud
Selection criteria: We selected RCTs that assessed the effects of low GI diets, over a minimum of 4 weeks, on CHD and risk factors for CHD. Participants included were adults with at least one major risk factor for CHD e.g. abnormal lipids, diabetes or being overweight or who had previously been diagnosed with CHD.\ud
Data collection and analysis: Two reviewers independently assessed trial quality and extracted data. Authors of the included studies were contacted for additional information where necessary.\ud
Main results: Twenty-one RCTs were included, with a total of 713 participants randomised. No studies were found that reported the effect of low GI diets on CHD mortality or CHD events and morbidity. All 21 included studies report the effect of low GI diets on risk factors for CHD. Meta-analysis detected limited and weak evidence of slightly lower total cholesterol with low glycaemic index diets. However, when only studies on diabetics were included in the analysis, no evidence of an effect on total cholesterol was found. There is little evidence from the combination of studies in meta-analysis that low glycaemic index diets have an effect on LDL cholesterol, HDL cholesterol, triglycerides, glycosylated haemoglobin (HbA1c), fasting glucose or fasting insulin levels. However, the majority of individual studies do report slightly lower levels of glycosylated haemoglobin (HbA1c) with low GI diets.\ud
Authors' conclusions: There is no evidence from RCTs to show an effect of low GI diets on coronary heart disease. Weak evidence for minor effects on some CHD risk factors was found. Many of the trials identified were short-term, of poor quality and did not have sufficient power to detect clinically important differences. The combined evidence from the studies suggests that any beneficial effect of low glycaemic index diets on CHD and its risk factors is small. There is a need for well designed, adequately powered, randomised controlled studies, of greater than 12 weeks duration to assess the true effects of low glycaemic index diets for CHD