Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2001
ReviewUmbilical vein injection for management of retained placenta.
If a retained placenta is left untreated, there is a high risk of maternal death. However, manual removal of the placenta is an invasive procedure with its own serious complications of haemorrhage, infection or genital tract trauma. ⋯ Umbilical vein injection of saline solution plus oxytocin appears to be effective in the management of retained placenta. Saline solution alone does not appear be more effective than expectant management. Further research into umbilical vein injection of oxytocin, prostaglandins or plasma expander is warranted.
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Tartrazine is the best known and one of the most commonly used food additives. Food colorants are also used in many medications as well as foods. There has been conflicting evidence as to whether tartrazine causes exacerbations of asthma with some studies finding a positive association especially in individuals with cross-sensitivity to aspirin. ⋯ Due to the paucity of available evidence, it is not possible to provide firm conclusions as to the effects of tartrazine on asthma control. However, the six RCTs that could be included in this review all arrived at the same conclusion. Routine tartrazine exclusion may not benefit most patients, except those very few individuals with proven sensitivity.
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Cochrane Db Syst Rev · Jan 2001
ReviewInhaled nitric oxide for respiratory failure in preterm infants.
Inhaled nitric oxide has been proven effective in term infants with hypoxic respiratory failure. The pathophysiology of respiratory failure, and the potential risks, differ substantially in preterm infants. Analysis of the efficacy and toxicities of inhaled nitric oxide in infants born before 35 weeks is therefore necessary. ⋯ The currently published evidence from randomized trials does not support the use of inhaled nitric oxide in preterm infants with hypoxic respiratory failure. There is a possible reduction in the severity of chronic lung disease (shortened duration of assisted ventilation). Because of lack of power, it is not possible to eliminate the possibility of substantial improvements in outcome. Further studies should be performed.
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Cochrane Db Syst Rev · Jan 2001
ReviewHelium-oxygen mixture for nonintubated acute asthma patients.
Helium and oxygen mixtures (heliox), have been used sporadically in respiratory medicine for decades. Their use in acute respiratory emergencies such as asthma has been the subject of considerable debate. Despite the lapse of more than 60 years since it was first proposed, the role of heliox in treating patients with acute severe asthma is unclear. ⋯ The existing evidence does not provide support for the administration of helium-oxygen mixtures to patients presenting to the emergency department with moderate to severe acute asthma. Heliox treatment does not have a role in the initial treatment of patients with acute asthma. These conclusions are based upon between-group comparisons and small studies. Additional research in this setting may be warranted.
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Acute psychotic illness, especially when associated with agitated or violent behaviour, requires urgent pharmacological tranquillisation or sedation. Clotiapine, a dibenzothiazepine neuroleptic, is being used for this purpose in several countries. ⋯ We found no significant evidence to support the use of clotiapine rather than other 'standard' or 'non-standard' treatments for the management of acute psychotic illness. The trials included in this review all present important methodological flaws. We do not wish to discourage clinicians from using clotiapine in the psychiatric emergency, we would just like to point out the fact that good quality controlled trials are needed on this subject.