Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewNonsteroidal anti-inflammatory drugs for heavy menstrual bleeding.
Heavy menstrual bleeding is an important cause of ill health in premenopausal women. Although surgery is often used as a treatment, a range of medical therapies are also available. Nonsteroidal anti-inflammatory drugs or prostaglandin synthetase inhibitors reduce prostaglandin levels which are elevated in women with excessive menstrual bleeding and also may have a beneficial effect on dysmenorrhoea. ⋯ NSAIDs reduce heavy menstrual bleeding when compared with placebo but are less effective than either tranexamic acid or danazol. However, adverse events are more severe with danazol therapy. In the limited number of small scale studies suitable for evaluation, no significant difference in efficacy was demonstrated between NSAIDs and other medical treatments such as oral progestogen given in the luteal phase, ethamsylate, oral contraceptive pill and the progesterone releasing IUS.
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Cochrane Db Syst Rev · Jan 2000
ReviewElastic compression stockings for prevention of deep vein thrombosis.
One of the settings in which deep vein thrombosis (DVT) in the lower limb and pelvic veins occurs is prolonged immobilisation in hospital for various surgical and medical illnesses. Use of graduated compression stockings (GCS) in these patients has been proposed to decrease the risk of DVT. ⋯ Analysis of these RCT's confirm that GCS are effective in diminishing the risk of DVT in hospitalised patients. Data examination also suggests, that GCS on a background of another method of prophylaxis is even more effective than GCS alone.
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Cochrane Db Syst Rev · Jan 2000
ReviewFolic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis.
To assess the effects of folic acid and folinic acid in reducing the mucosal and gastrointestinal (GI) and haematologic side effects of low-dose of Methotrexate (MTX) in patients with Rheumatoid Arthritis (RA) and to determine whether or not folate supplementation alters MTX efficacy. ⋯ The results support the protective effect of folate supplementation in reducing MTX side effects related to the oral and GI systems. We could not determine if folic was different from folinic acid. Therefore, for folinic acid to be considered cost-effective it must be found more effective than folic acid at reducing MTX side effects.
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Low back pain is one of the most common and costly musculoskeletal problems in modern societies. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. ⋯ Based on the studies reviewed, there is insufficient evidence to recommend massage as a stand-alone treatment for non-specific low back pain. There is a need for high quality controlled trials to further evaluate the effects of massage for this condition.
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Cochrane Db Syst Rev · Jan 2000
ReviewChest physiotherapy for preventing morbidity in babies being extubated from mechanical ventilation.
This section is under preparation and will be included in the next issue. ⋯ The results of this review do not allow development of clear guidelines for clinical practice. Caution is required when interpreting the possible positive effects of chest physiotherapy of a reduction in the use of reintubation and the trend for decreased post-extubation atelectasis as the numbers of babies studied are small, the results are not consistent across trials, data on safety are insufficient, and applicability to current practice may be limited.