Cochrane Db Syst Rev
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Venous leg ulceration is a common problem, representing a significant burden on the patient and the healthcare system. They are caused by venous insufficiency and tend to be chronic and recurring. Management usually includes use of wound dressings plus compression stockings or bandages. It has been suggested that therapeutic ultrasound may have an adjuvant effect and promote healing however its effects are unclear. ⋯ The available evidence suggests that ultrasound may increase healing of venous leg ulcers. These conclusions are based on the results of only eight small studies of generally poor quality and therefore should be interpreted with caution.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisPhysical training for interstitial lung disease.
Interstitial lung disease (ILD) is characterised by reduced functional capacity, dyspnoea and exercise-induced hypoxia. Physical training is beneficial for people with other chronic lung conditions, however its effects in ILD have not been well characterised. ⋯ Physical training is safe for people with ILD. Improvements in functional exercise capacity, dyspnoea and quality of life are seen immediately following training, with benefits also evident in IPF. There is little evidence regarding longer-term effects of physical training.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisInterventions for improving communication with children and adolescents about their cancer.
Communication with children and adolescents with cancer about their disease and treatment and the implications of these is an important aspect of good quality care. It is often poorly performed in practice. Various interventions have been developed that aim to enhance communication involving children or adolescents with cancer. ⋯ Interventions to enhance communication involving children and adolescents with cancer have not been widely or rigorously assessed. The weak evidence that exists suggests that some children and adolescents with cancer may derive some benefit from specific information-giving programs, from support before and during particular procedures, and from interventions that aim to facilitate their reintegration into school and social activities. More research is needed to investigate the effects of these and other related interventions.
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Low-back pain is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. ⋯ Massage might be beneficial for patients with subacute and chronic non-specific low-back pain, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this need confirmation. More studies are needed to confirm these conclusions, to assess the impact of massage on return-to-work, and to determine cost-effectiveness of massage as an intervention for low-back pain.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisMonitoring of stimulated cycles in assisted reproduction (IVF and ICSI).
Traditional monitoring of ovarian hyperstimulation during in vitro fertilisation (IVF) treatment has included ultrasonography plus serum estradiol concentration to ensure safe practice by reducing the incidence and severity of ovarian hyperstimulation syndrome (OHSS). The need for intensive monitoring during ovarian stimulation in IVF is controversial. It has been suggested that close monitoring is time consuming, expensive and inconvenient for the woman and simplification of IVF therapy by using ultrasound only should be considered. This systematic review assessed the effects of ovarian monitoring by ultrasound only versus ultrasound plus serum estradiol measurement on IVF outcomes and the occurrence of OHSS in women undergoing stimulated cycles in IVF and intra-cytoplasmic sperm injection (ICSI) treatment. ⋯ There is no evidence from randomised trials to support cycle monitoring by ultrasound plus serum estradiol as more efficacious than cycle monitoring by ultrasound only on outcomes of live birth and pregnancy rates. A large well-designed randomised controlled trial is needed that reports on live birth rates and pregnancy, with economic evaluation of the costs involved and the views of the women undergoing cycle monitoring. A randomised trial with sufficiently large sample size to test the effects of different monitoring protocols on OHSS, a rare outcome, will pose a great challenge. Until such a trial is considered feasible, cycle monitoring by transvaginal ultrasound plus serum estradiol may need to be retained as a precautionary good practice point.