Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2001
ReviewCabergoline for levodopa-induced complications in Parkinson's disease.
Long term levodopa therapy in Parkinson's disease is associated with the development of motor complications including abnormal involuntary movements and a shortening response to each dose (wearing off phenomenon). It is thought that dopamine agonists can reduce the duration of immobile off periods and the need for levodopa therapy whilst maintaining or improving motor impairments and only minimally increasing dopaminergic adverse events. ⋯ In the management of the motor complications seen in Parkinson's disease, cabergoline can be used to reduce levodopa dose and modestly improve motor impairment and disability with an acceptable adverse event profile. These conclusions are based on, at best, medium term evidence.
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Cochrane Db Syst Rev · Jan 2001
ReviewInterventions to improve the management of diabetes mellitus in primary care, outpatient and community settings.
Diabetes is a common chronic disease that is increasingly managed in primary care. Different systems have been proposed to manage diabetes care. ⋯ Multifaceted professional interventions can enhance the performance of health professionals in managing patients with diabetes. Organisational interventions that improve regular prompted recall and review of patients (central computerised tracking systems or nurses who regularly contact the patient) can also improve diabetes management. The addition of patient-oriented interventions can lead to improved patient health outcomes. Nurses can play an important role in patient-oriented interventions, through patient education or facilitating adherence to treatment.
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Cochrane Db Syst Rev · Jan 2001
ReviewClosed suction surgical wound drainage after orthopaedic surgery.
Closed suction drainage systems are frequently used to drain fluids, particularly blood, from surgical wounds. The aim of these systems is to reduce the occurrence of wound haematomas and infection. ⋯ There is insufficient evidence from randomised trials to support or refute the routine use of closed suction drainage in orthopaedic surgery. Further randomised trials are required before definite conclusions can be made.
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Cochrane Db Syst Rev · Jan 2001
ReviewDiuretic therapy for newborn infants with posthemorrhagic ventricular dilatation.
Intraventricular hemorrhage remains a serious complication of premature birth and post hemorrhagic hydrocephalus still has no satisfactory treatment. Acetazolamide and furosemide, which both reduce the production of cerebrospinal fluid, have been suggested as non-invasive therapies to reduce hydrocephalus and the need for ventriculo-peritoneal (V-P) shunting. ⋯ Acetazolamide and furosemide therapy is neither effective nor safe in treating post hemorrhagic ventricular dilatation. Acetazolamide and furosemide cannot be recommended as therapy for post hemorrhagic hydrocephalus.
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Cochrane Db Syst Rev · Jan 2001
ReviewSurgical interventions for treating distal radial fractures in adults.
Fracture of the distal radius is a common clinical problem, particularly in older white women with osteoporosis. ⋯ The 44 randomised trials do not provide robust evidence for most of the decisions necessary in the management of these fractures. Although, in particular, there is some evidence to support the use of external fixation or percutaneous pinning, their precise role and methods are not established. It is also unclear whether surgical intervention of most fracture types will produce consistently better long-term outcomes. There is a need for good quality evidence for the surgical management of these fractures.