Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewMultidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults.
Multidisciplinary biopsychosocial rehabilitation programs for neck and shoulder pain require substantial staff and financial resources. Despite questionable scientific evidence of their effectiveness, they are widely used. Neck and shoulder complaints are common among working age adults and they are often associated with physical work load and stress. Pain in the neck and shoulder area cause biopsychosocial difficulties for the patient especially if disability due to pain is prolonged. To help patients with biopsychosocial problems or to prevent their development, multidisciplinary biopsychosocial programs are applied on rehabilitation for neck and shoulder pain patients. Nevertheless multidisciplinary treatment programmes are often laborious and rather long processes and require good collaboration between the patient, the rehabilitation team and the work place. ⋯ We conclude that there appears to be little scientific evidence for the effectiveness of multidisciplinary biopsychosocial rehabilitation compared with other rehabilitation facilities on neck and shoulder pain. Multidisciplinary rehabilitation is a commonly used intervention for chronic neck and shoulder complaints, therefore we see an urgent need for high quality trials in this field.
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To assess the effectiveness and cost-effectiveness of compression bandaging and stockings in the treatment of venous leg ulcers. ⋯ Compression increases ulcer healing rates compared with no compression. Multi-layered systems are more effective than single-layered systems. High compression is more effective than low compression but there are no clear differences in the effectiveness of different types of high compression.
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Cochrane Db Syst Rev · Jan 2000
ReviewNebulized racemic epinephrine for extubation of newborn infants.
Following a period of mechanical ventilation, post-extubation upper airway obstruction can occur in newborn infants, especially after prolonged, traumatic or multiple intubations. The subsequent increase in upper airway resistance may lead to respiratory insufficiency and failure of extubation. The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulised epinephrine immediately post-extubation in some neonatal units. It is also recommended for neonates with post-extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. ⋯ randomised controlled trials are needed comparing inhaled nebulised racemic epinephrine with placebo in neonates post-extubation. This should be looked at both as a routine treatment post-extubation and as specific treatment for post-extubation upper airway obstruction. Study populations should include the group of infants at highest risk for upper airway obstruction from mucosal swelling because of their small glottic and sub-glottic diameters (ie those infants with birthweights less than 1000 grams).
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Cochrane Db Syst Rev · Jan 2000
ReviewEmollient ointment for preventing infection in preterm infants.
This section is under preparation and will be included in the next issue. ⋯ In two small studies, prophylactic application of emollient ointment decreased transepidermal water loss, decreased the severity of dermatitis, and decreased the risk of suspect sepsis and proven sepsis. Further clinical studies are warranted to validate these results.
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The cause of Guillain-Barré syndrome (GBS) is inflammation of the peripheral nerves which corticosteroids would be expected to benefit. ⋯ Corticosteroids should not be used in the treatment of Guillain-Barré syndrome. If a patient with Guillain-Barré syndrome needs corticosteroid treatment for some other reason its use will probably not do harm. The effect of intravenous methylprednisolone combined with intravenous immunoglobulin in Guillain-Barré syndrome is being tested with a randomised trial.