Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisInterventions for treating oral candidiasis for patients with cancer receiving treatment.
Treatment of cancer is increasingly effective but is associated with short and long term side effects. Oral side effects, including oral candidiasis, remain a major source of illness despite the use of a variety of agents to treat them. ⋯ There is weak and unreliable evidence that the absorbed drug, ketoconazole, may eradicate oral candidiasis and that a higher dose of the partially absorbed drug, clotrimazole, may give greater benefit than a lower 10 mg dose, however, researchers may wish to prevent rather than treat oral candidiasis. Further well designed, placebo-controlled trials assessing the effectiveness of old and new interventions for treating oral candidiasis are needed.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisBed rest for acute uncomplicated myocardial infarction.
Bed rest is prescribed to all patients with acute myocardial infarction (AMI), but to a variable extent. Current guidelines (American College of Cardiology/ American Heart Association) recommend at least 12 hours bed rest in patients with uncomplicated ST-elevation myocardial infarction, however the basis for this recommendation is unclear. ⋯ Bed rest ranging from 2 to 12 days appears to be as safe as longer periods of bed rest. The quality of most trials is unsatisfactory. Current bed rest recommendations are not supported by the existing evidence as the optimal duration of bed rest is unknown. The lack of adequate trials is surprising, considering the large size of several studies to compare effectiveness of drugs on people with AMI.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisEffects of nonsteroidal anti-inflammatory drugs on postoperative renal function in adults with normal renal function.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can play a major role in the management of acute pain in the peri-operative period. However, there are conflicting views on whether NSAIDs are associated with adverse renal effects. ⋯ NSAIDs caused a clinically unimportant transient reduction in renal function in the early postoperative period in patients with normal preoperative renal function. NSAIDs should not be withheld from adults with normal preoperative renal function because of concerns about postoperative renal impairment.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisRoutine abdominal drainage for uncomplicated open cholecystectomy.
Cholecystectomy is the removal of gallbladder and is performed mainly for symptomatic gallstones. Although laparoscopic cholecystectomy is currently preferred over open cholecystectomy for elective cholecystectomy, reports of randomised clinical trials comparing the choice of cholecystectomy (open or laparoscopic) in acute cholecystitis are still being conducted. Drainage in open cholecystectomy is a matter of considerable debate. Surgeons use drains primarily to prevent subhepatic abscess or bile peritonitis from an undrained bile leak. Critics of drain condemn drain use as it increases wound and chest infection. ⋯ Drains increase the harms to the patient without providing any additional benefit for patients undergoing open cholecystectomy and should be avoided in open cholecystectomy.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisOvarian stimulation protocols (anti-oestrogens, gonadotrophins with and without GnRH agonists/antagonists) for intrauterine insemination (IUI) in women with subfertility.
Intrauterine insemination (IUI) combined with ovarian hyperstimulation (OH) has been demonstrated to be an effective form of treatment for subfertile couples. Several ovarian stimulation protocols combined with IUI have been proposed, but it is still not clear which stimulation protocol and which dose is the most cost-effective. ⋯ Robust evidence is lacking but based on the available results gonadotrophins might be the most effective drugs when IUI is combined with ovarian hyperstimulation. When gonadotrophins are applied it might be done on a daily basis. When gonadotrophins are used for ovarian stimulation low dose protocols are advised since pregnancy rates do not differ from pregnancy rates which result from high dose regimen, whereas the chances to encounter negative effects from ovarian stimulation such as multiples and OHSS are limited with low dose gonadotrophins. Further research is needed for each comparison made.