Cochrane Db Syst Rev
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Chest radiography is widely used during the management of acute lower respiratory infections, but the benefits are unknown. ⋯ There is no evidence that chest radiography improves outcome in outpatients with acute lower respiratory infection. The findings do not exclude a potential effect of radiography, but the potential benefit needs to be balanced against the hazards and expense of chest radiography. The findings apply to outpatients only.
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Cochrane Db Syst Rev · Jan 2008
ReviewEarly versus delayed laparoscopic cholecystectomy for biliary colic.
Biliary colic is one of the commonest indications for laparoscopic cholecystectomy. Laparoscopic cholecystectomy involves several months of waiting if performed electively. However, patients can develop life-threatening complications during this waiting period. ⋯ Based on evidence from only one high-bias risk trial, it appears that early laparoscopic cholecystectomy (< 24 hours of diagnosis of biliary colic) decreases the morbidity during the waiting period for elective laparoscopic cholecystectomy, decreases the rate of conversion to open cholecystectomy, decreases operating time, and decreases hospital stay. Further randomised clinical trials are necessary to confirm or refute this finding.
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Cochrane Db Syst Rev · Jan 2008
ReviewWITHDRAWN: Glucocorticoids for acute viral bronchiolitis in infants and young children.
Systemic glucocorticoids have been widely prescribed for use in infants and young children with acute viral bronchiolitis but the actual benefit of this intervention requires clarification. ⋯ No benefits were found in either LOS or clinical score in infants and young children treated with systemic glucocorticoids as compared to placebo. There were no differences in these outcomes between treatment groups; either in the pooled analysis or in any of the sub analyses. Among the three studies evaluating hospital admission rates following the initial hospital visit there was no difference between treatment groups. There were no differences found in respiratory rate, haemoglobin oxygen saturation, hospital revisit or readmission rates. Subgroup analyses were significantly limited by the low number of studies in each comparison. Marked study heterogeneity and occasionally conflicting direction of benefit between trials suggests that these results should be interpreted with caution. Specific data on the harm of corticosteroid therapy in this patient population are lacking. Available evidence suggests that corticosteroid therapy is not of benefit in this patient group.
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Cochrane Db Syst Rev · Jan 2008
ReviewModest cooling therapies (35 degrees C to 37.5 degrees C) for traumatic brain injury.
A recent retrospective study suggested that after traumatic brain injury, patients with a raised body temperature have an unfavourable outcome compared to patients that have a normal body temperature. ⋯ There is no evidence that interventions aimed at reducing body temperature to between 35 degrees C and 37.5 degrees C in the first week after TBI improves patient outcomes. Trials designed to explore the effect of these interventions on patient-centred outcomes are needed.
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Cochrane Db Syst Rev · Jan 2008
ReviewMedically assisted nutrition for palliative care in adult patients.
Many palliative care patients have a reduced oral intake during their illness. The management of this can include the provision of medically assisted nutrition with the aim of prolonging the length of life of a patient, improving their quality of life, or both. ⋯ There are insufficient good quality trials to make any recommendations for practice with regards to the use of medically assisted nutrition in palliative care patients.