Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisOpioids for neonates receiving mechanical ventilation.
Mechanical ventilation is a potentially painful and discomforting intervention widely used in neonatal intensive care units. Newborn babies (neonates) demonstrate increased sensitivity to pain, which may affect clinical and neurodevelopmental outcomes. The use of drugs that reduce pain might be important in improving survival and neurodevelopmental outcomes. ⋯ There is insufficient evidence to recommend routine use of opioids in mechanically ventilated newborns. Opioids should be used selectively, when indicated by clinical judgment and evaluation of pain indicators. If sedation is required, morphine is safer than midazolam. Further research is needed.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisPsychosocial interventions for people with both severe mental illness and substance misuse.
Even low levels of substance misuse by people with a severe mental illness can have detrimental effects. ⋯ We included 25 RCTs and found no compelling evidence to support any one psychosocial treatment over another to reduce substance use (or improve mental state) by people with serious mental illnesses. Furthermore, methodological difficulties exist which hinder pooling and interpreting results; high drop out rates, varying fidelity of interventions, varying outcome measures, settings and samples and comparison groups may have received higher levels of treatment than standard care. Further studies are required which address these concerns and improve the evidence in this important area.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisCranberries for preventing urinary tract infections.
Cranberries have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs). ⋯ There is some evidence that cranberry juice may decrease the number of symptomatic UTIs over a 12 month period, particularly for women with recurrent UTIs. It's effectiveness for other groups is less certain. The large number of dropouts/withdrawals indicates that cranberry juice may not be acceptable over long periods of time. It is not clear what is the optimum dosage or method of administration (e.g. juice, tablets or capsules). Further properly designed studies with relevant outcomes are needed.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisChinese herbal medicine suxiao jiuxin wan for angina pectoris.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisVaccines for preventing pneumococcal infection in adults.
Diseases caused by Streptococcus pneumoniae(S. pneumoniae) continue to cause substantial morbidity and mortality throughout the world. Whilst pneumococcal polysaccharide vaccines (PPV) have the potential to prevent disease and death, the degree of protection afforded against various clinical endpoints and within different populations is uncertain. ⋯ This meta-analysis provides evidence supporting the recommendation for PPV to prevent IPD in adults. The evidence from RCTs is less clear with respect to adults with chronic illness. This might be because of lack of effect or lack of power in the studies. The meta-analysis does not provide compelling evidence to support the routine use of PPV to prevent all-cause pneumonia or mortality.