British medical bulletin
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British medical bulletin · Jun 2016
Meta Analysis Comparative StudyCore decompression versus other joint preserving treatments for osteonecrosis of the femoral head: a meta-analysis.
Osteonecrosis of femoral head (ONFH) leads to hip osteoarthritis (HOA); among joint preserving treatments (JPT), the role of core decompression (CD) is still debated. We assessed the efficacy of CD compared with all other JPT in delaying the natural osteonecrosis evolution to HOA. ⋯ Further studies are needed to identify the best therapeutic approach to the ONFH.
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British medical bulletin · Jun 2016
ReviewThe use of adjustable gastric bands for management of severe and complex obesity.
Obesity levels in the UK have reached a sustained high and ∼4% of the population would be candidates for bariatric surgery based upon current UK NICE guidelines, which has important implications for Clinical Commissioning Groups. ⋯ Better RCT evidence is needed including clinical effectiveness and economic analysis to answer the important question 'which is the best of the three operations most frequently performed?' This review considers the current evidence for gastric banding for the treatment of severe and complex obesity.
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British medical bulletin · Jun 2016
ReviewRepurposing drugs for treatment of tuberculosis: a role for non-steroidal anti-inflammatory drugs.
The number of cases of drug-resistant Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), has risen rapidly in recent years. This has led to the resurgence in repurposing existing drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs), for anti-TB treatment. ⋯ It is essential that clinical trials of NSAIDs continue, in order to assess their suitability for addition to the current TB treatment regimen. Repurposing molecules such as NSAIDs is a vital, low-risk strategy to combat the trend of rapidly increasing antibiotic resistance.
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British medical bulletin · Jun 2016
ReviewCoronary heart disease and household air pollution from use of solid fuel: a systematic review.
Evidence is emerging that indoor air pollution (IAP) from use of solid fuels for cooking and heating may be an important risk factor for coronary heart disease (CHD). ⋯ The need for such research is particularly pressing because the incidence of CHD in developing countries is rising, and IAP may interact synergistically with the risk factors that are driving that increase. Furthermore, relatively cheap methods are available to reduce IAP from use of solid fuels, and there are indications from intervention studies that these may impact beneficially on CHD as well as other diseases caused by such pollution.
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The incidence of vertebral osteomyelitis is increasing, attributed to an ageing population with inherent co-morbidities and improved case ascertainment. ⋯ Further studies are needed to define the most effective technique for spinal biopsies to maximize determining aetiology. High-quality trials are required to provide an evidence base for both the medical and surgical management of vertebral osteomyelitis, including challenging medical management as the default option.