Cochrane Db Syst Rev
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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 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 AnalysisCorticosteroids for managing tuberculous meningitis.
Tuberculous meningitis, a serious form of tuberculosis that affects the meninges covering the brain and spinal cord, is associated with high mortality and disability among survivors. Corticosteroids have been used as an adjunct to antituberculous drugs to improve the outcome, but their role is controversial. ⋯ Corticosteroids should be routinely used in HIV-negative people with tuberculous meningitis to reduce death and disabling residual neurological deficit amongst survivors. However, there is not enough evidence to support or refute a similar conclusion for those who are HIV positive.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisChinese herbal medicine suxiao jiuxin wan for angina pectoris.
Suxiao jiuxin wan is widely used in China for angina pectoris. ⋯ Suxiao jiuxin wan appears to be effective in the treatment of angina pectoris and no serious side effects were identified. However, the evidence remains weak due to poor methodological quality of including studies.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisNon-steroidal anti-inflammatory drugs for low back pain.
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently prescribed medications worldwide and are widely used for patients with low-back pain. Selective COX-2 inhibitors are currently available and used for patients with low-back pain. ⋯ The evidence from the 65 trials included in this review suggests that NSAIDs are effective for short-term symptomatic relief in patients with acute and chronic low-back pain without sciatica. However, effect sizes are small. Furthermore, there does not seem to be a specific type of NSAID which is clearly more effective than others. The selective COX-2 inhibitors showed fewer side effects compared to traditional NSAIDs in the RCTs included in this review. However, recent studies have shown that COX-2 inhibitors are associated with increased cardiovascular risks in specific patient populations.