Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisPatient education for neck pain with or without radiculopathy.
Neck disorders are common, disabling, and costly. The effectiveness of patient education strategies is unclear. ⋯ This review has not shown effectiveness for educational interventions in various disorder types and follow-up periods, including advice to activate, advice on stress coping skills, and 'neck school'. In future research, further attention to methodological quality is necessary. Studies of multimodal interventions should consider study designs, such as factorial designs, that permit discrimination of the specific educational components.
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Cochrane Db Syst Rev · Jan 2008
Review Meta Analysis Comparative StudyNon-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary edema.
Non-invasive positive pressure ventilation (NPPV) has been widely used to alleviate signs and symptoms of respiratory distress due to cardiogenic pulmonary edema. NPPV prevents alveolar collapse and helps redistribute intra-alveolar fluid, improving pulmonary compliance and reducing the pressure of breathing. ⋯ NPPV, especially CPAP, in addition to standard medical care is an effective and safe intervention for the treatment of adult patients with acute cardiogenic pulmonary edema.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisCorticosteroids for preventing postherpetic neuralgia.
Postherpetic neuralgia is a common serious complication of herpes zoster. Corticosteroids are anti-inflammatory and might be beneficial. ⋯ There was insufficient evidence to conclude that corticosteroids are safe or effective in the prevention of postherpetic neuralgia. More randomised controlled trials with a greater number of participants are needed to determine reliably whether there is real benefit (or harm) from the use of corticosteroid therapy to prevent postherpetic neuralgia. Future trials should measure function and quality of life.
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Cochrane Db Syst Rev · Jan 2008
Review Meta Analysis Comparative StudyMidwife-led versus other models of care for childbearing women.
Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led and other models of care. ⋯ All women should be offered midwife-led models of care and women should be encouraged to ask for this option.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisTreatment of acute cryptococcal meningitis in HIV infected adults, with an emphasis on resource-limited settings.
Despite the advent and increasingly wide availability of antiretroviral therapy, cryptococcal meningitis (CM) remains a significant cause of mortality and morbidity amongst individuals with HIV infection in resource-limited settings. The ideal management of CM remains unclear. The aim of this review is to assess the evidence for deciding on which antifungal regimen to use as well as other modalities of management to utilise especially resource poor settings in order to achieve the best possible outcome and enable an individual with CM to survive their acute illness and benefit from antiretroviral therapy. ⋯ The main aim of this review was to determine the best treatment for cryptococcal meningitis in resource-limited settings. In these settings usually only AmB and fluconazole are available. No studies suitable for inclusion in the review were found that compared these two drugs. Therefore we are unable to recommend either treatment as superior to the other. The recommended treatment for CM is a combination of AmB and flucytosine. The optimal dosing of AmB remains unclear. Liposomal AmB is associated with less adverse events than AmB and may be useful in selected patients where resources allow.Future research into the management of cryptococcal meningitis in resource-limited settings should focus on the most effective use of medications that are available in these settings.Flucytosine in combination with AmB leads to faster and increased sterilisation of CSF compared to using AmB alone. As Flucytosine is often not available in developing countries, policy makers and national departments of heath should consider procuring this drug for HIV treatment programmes.