Cochrane Db Syst Rev
-
Cochrane Db Syst Rev · Jan 2004
ReviewAntiplatelet agents for preventing pre-eclampsia and its complications.
Pre-eclampsia is associated with deficient intravascular production of prostacyclin, a vasodilator, and excessive production of thromboxane, a platelet-derived vasoconstrictor and stimulant of platelet aggregation. These observations led to the hypotheses that antiplatelet agents, low-dose aspirin in particular, might prevent or delay the development of pre-eclampsia. ⋯ Antiplatelet agents, in this review largely low-dose aspirin, have small-moderate benefits when used for prevention of pre-eclampsia. Further information is required to assess which women are most likely to benefit, when treatment is best started, and at what dose.
-
Our previous review examining conservative treatments for whiplash was published in 2001. Since then, new trials have been published.Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms: WAD Grade 0 indicates no complaints or physical signs; Grade 1 indicates neck complaints but no physical signs; Grade 2 indicates neck complaints and musculoskeletal signs; Grades 3 and 4 indicate neck complaints and neurological signs or fracture/dislocation, respectively. ⋯ When looking at the actual data presented in the current included trials, our conclusion from the previous version of this review, that 'rest makes rusty', can no longer be justified. There is a trend suggesting that active interventions are more effective than passive ones, but no clear conclusion can be drawn. We can draw no conclusion about the most effective therapy for patients with chronic WAD, because only one low quality trial was found.
-
Cochrane Db Syst Rev · Jan 2004
Review Meta AnalysisEffects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.
One of the controversies in preventive medicine is, whether a general reduction in sodium intake can decrease the blood pressure of a population and thereby reduce cardiovascular mortality and morbidity. In recent years the debate has been extended by studies indicating that reducing sodium intake has effects on the hormone and lipid profile. ⋯ The magnitude of the effect in Caucasians with normal blood pressure does not warrant a general recommendation to reduce sodium intake. Reduced sodium intake in Caucasians with elevated blood pressure has a useful effect to reduce blood pressure in the short-term. The results suggest that the effect of low versus high sodium intake on blood pressure was greater in Black and Asian patients than in Caucasians. However, the number of studies in black (8) and Asian patients (1) was insufficient for different recommendations. Additional long-term trials of the effect of reduced dietary sodium intake on blood pressure, metabolic variables, morbidity and mortality are required to establish whether this is a useful prophylactic or treatment strategy.
-
Cochrane Db Syst Rev · Jan 2004
ReviewTreatment of latent tuberculosis infection in HIV infected persons.
Individuals with HIV infection are at an increased risk of developing active tuberculosis. It is known that treatment of latent tuberculosis infection (LTBI), also referred to as preventive therapy or chemoprophylaxis, helps to prevent progression to active disease in human immunodeficiency virus (HIV) negative populations. However, the extent and magnitude of protection (if any) associated with preventive therapy in those infected with HIV should be quantified. ⋯ Treatment of latent tuberculosis infection (LTBI) reduces the risk of active tuberculosis in HIV positive individuals with a positive tuberculin skin test. The choice of regimen will depend on factors such as cost, adverse effects, adherence and drug resistance. Future studies should assess these aspects. In addition, trials evaluating the long-term effects of anti-tuberculosis chemoprophylaxis and the influence of level of immunocompromise on effectiveness are needed.
-
Cochrane Db Syst Rev · Jan 2004
ReviewHigh-frequency ventilation versus conventional ventilation for treatment of acute lung injury and acute respiratory distress syndrome.
High-frequency ventilation is often used to treat patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) but the effect of this treatment on clinical outcomes has not been well established. ⋯ There is not enough evidence to conclude whether high-frequency ventilation reduces mortality or long-term morbidity in patients with ALI or ARDS; further trials are needed.