Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2001
ReviewD-Penicillamine for preventing retinopathy of prematurity in preterm infants.
Retinopathy of prematurity remains a common problem. A low rate of this disorder was unexpectedly observed among infants treated with intravenous d-penicillamine to prevent hyperbilirubinemia. This observation led to the investigation of its use to prevent retinopathy of prematurity. ⋯ D-penicillamine is unlikely to affect survival, and may reduce the incidence of acute ROP among survivors. Studies to date justify further investigation of this drug in a broader population; careful attention to possible side effects is needed.
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People with acute psychotic illnesses, especially when associated with agitated or violent behaviour, may require urgent pharmacological tranquillisation or sedation. Droperidol, a butyrophenone neuroleptic, is used for this purpose in several countries. ⋯ This is an important and surprisingly under-researched area. Use of droperidol for the emergency situation is currently justified on experience rather than evidence from well conducted and reported randomised trials.
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Cochrane Db Syst Rev · Jan 2001
ReviewFormula milk versus preterm human milk for feeding preterm or low birth weight infants.
Preterm human breast milk, compared with artificial formula milk, may provide insufficient nutrition for preterm or low birth weight infants. However, human milk may confer advantages in terms of a decreased incidence of gastrointestinal and neurodevelopmental adverse outcomes. ⋯ There are very limited data from randomised trials of feeding preterm or low birth weight infants with formula milk compared with preterm human milk. This may relate to a perceived difficulty of allocating an alternative enteral feed to an infant in cases where the infant's mother wishes to feed with expressed breast milk.
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Cochrane Db Syst Rev · Jan 2001
ReviewVocational rehabilitation for people with severe mental illness.
Unemployment rates are high amongst people with severe mental illness, yet surveys show that most want to work. Vocational rehabilitation services exist to help mentally ill people find work. Traditionally, these services have offered a period of preparation (Pre-vocational Training), before trying to place clients in competitive (i.e. open) employment. More recently, some services have begun placing clients in competitive employment immediately whilst providing on-the-job support (Supported Employment). It is unclear which approach is most effective. ⋯ Supported employment is more effective than Pre-vocational Training in helping severely mentally ill people to obtain competitive employment. There is no clear evidence that Pre-vocational Training is effective.
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Infection with Streptococcus pneumoniae is an important cause of pneumonia and other serious illnesses, particularly amongst those with certain high-risk medical conditions such as asthma. Although pneumococcal vaccine is routinely advocated for people with asthma, there is uncertainty about the evidence base that underpins this recommendation. ⋯ This review found very limited evidence to support the routine use of pneumococcal vaccine in people with asthma. A randomised trial of vaccine efficacy in children and adults with asthma is needed.