Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2001
ReviewSurgical methods for first trimester termination of pregnancy.
Different surgical methods for termination of pregnancy have evolved over the years: Dilatation and curettage, power operated vacuum aspiration, manual vacuum aspiration (MVA) or hysterotomy. Local or general anaesthesia is used for all methods. Preabortion medical or mechanical cervical preparation may reduce the incidence of cervical or uterine injuries. ⋯ The included studies do not indicate a preference of providers for one or the other method. The trials included are small and lack power to to present meaningful differences for rare outcomes between the groups. outcomes such as women's satisfaction, the need for pain relief or surgeons preference for the instrument have been inadequately addressed. No data outcomes, such as fertility after surgical abortion, are available.
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Cochrane Db Syst Rev · Jan 2001
ReviewTracheal suctioning without disconnection in intubated ventilated neonates.
Assisted mechanical ventilation is the mainstay of management of a variety of conditions affecting the neonate. However there are a number of potential hazards associated with this life saving intervention. New suctioning techniques have been introduced into clinical practice which aim to prevent or reduce these untoward effects. ⋯ Based upon the results of this review, there is insufficient evidence to decide between endotracheal suctioning with or without disconnection. There is, however, evidence of some benefit from performing suctioning without disconnection for some specific short-term outcomes. Further research should be undertaken to fully assess this practice with particular focus on extremely low birth weight infants and different modes of mechanical ventilation, and to address clinically important outcomes.
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Cochrane Db Syst Rev · Jan 2001
ReviewOral steroids for bronchiectasis (stable and acute exacerbations).
Inflammation plays a significant role in the pathophysiology of bronchiectasis. Two small studies have shown small benefits from inhaled corticosteroids and oral corticosteroids may be of benefit in bronchiectasis ⋯ There are no randomised trials upon which to make recommendations about the use of oral corticosteroids in acute or stable bronchiectasis.
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Jet-lag commonly affects air travellers who cross several time zones. It results from the body's internal rhythms being out of step with the day-night cycle at the destination. Melatonin is a pineal hormone that plays a central part in regulating bodily rhythms and has been used as a drug to re-align them with the outside world. ⋯ Melatonin is remarkably effective in preventing or reducing jet-lag, and occasional short-term use appears to be safe. It should be recommended to adult travellers flying across five or more time zones, particularly in an easterly direction, and especially if they have experienced jet-lag on previous journeys. Travellers crossing 2-4 time zones can also use it if need be. The pharmacology and toxicology of melatonin needs systematic study, and routine pharmaceutical quality control of melatonin products must be established. The effects of melatonin in people with epilepsy, and a possible interaction with warfarin, need investigation.
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Cochrane Db Syst Rev · Jan 2001
ReviewWhat is the role of stimulant laxatives in the management of childhood constipation and soiling?.
Constipation is extremely common in childhood and may lead to overflow soiling/encopresis. Standard treatment of the more severe case is to empty the bowels of impacted faeces by the use of oral or rectal laxatives and then maintain regular bowel movements by the continuation of osmotic and stimulant laxatives. ⋯ The need exists to establish a secure footing for treatment decisions and adequately sized trials are required to provide comparative data on commonly used drugs.