Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jul 2008
ReviewDecompressive surgery of lower limbs for symmetrical diabetic peripheral neuropathy.
Symmetrical peripheral neuropathy is a common complication of diabetic neuropathy. No treatments are known to be effective for progressive pain and sensory loss associated with diabetic neuropathy. Alternative effective treatment strategies have been sought. ⋯ The results of this review suggest that the role of decompressive surgery for diabetic symmetric distal neuropathy is unproven.
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Cochrane Db Syst Rev · Jul 2008
Review Meta AnalysisExtracorporeal membrane oxygenation for severe respiratory failure in newborn infants.
Neonatal extracorporeal membrane oxygenation (ECMO) is a complex procedure of life support used in severe but potentially reversible respiratory failure in term infants. Although the number of babies eligible for ECMO is small and the use of ECMO invasive and potentially expensive, its benefits may be high. ⋯ A policy of using ECMO in mature infants with severe but potentially reversible respiratory failure results in significantly improved survival without increased risk of severe disability. The benefit of ECMO for babies with diaphragmatic hernia is unclear. Further studies are needed to consider the optimal timing for introducing ECMO; to identify which infants are most likely to benefit; and to address the implications of neonatal ECMO during later childhood and adult life.
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Cochrane Db Syst Rev · Jul 2008
Review Meta AnalysisInterventions for skin changes caused by nerve damage in leprosy.
More than three million persons are disabled by leprosy worldwide. The main complication of sensory nerve damage is neuropathic ulceration, particularly of the feet. In this review we explored interventions that can prevent and treat secondary damage to skin and limbs. ⋯ One study suggested that topical ketanserin is more effective than clioquinol cream or zinc paste. Topical phenytoin (two studies) may be more effective than saline dressing regarding ulcer healing. For the other dressings the results were equivocal. Canvas shoes were a little better than PVC-boots, but not significantly, and the effect of double rocker shoes compared to below-knee plasters was no different in promoting the healing of ulcers. No side effects were documented. There is a lack of high quality research in the field of ulcer prevention and treatment in leprosy. New trials should follow the current standards for design and reporting of randomised controlled trials.
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Cochrane Db Syst Rev · Jul 2008
ReviewDrug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease.
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is the most common neurodegenerative disorder of the motor system in adults. Pain in ALS is a frequent symptom especially in the later stages of disease and can have a pronounced influence on quality of life and suffering. Treatment of pain therefore should be recognised as an important aspect of palliative care in ALS. ⋯ There is no evidence from randomised controlled trials about the management of pain in ALS. Further research on this important aspect of palliative care in ALS is needed. Randomised controlled trials should be initiated to determine the effectiveness of different analgesics for treatment of pain in ALS.
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Cochrane Db Syst Rev · Jul 2008
ReviewWITHDRAWN: Interventions for preventing tobacco smoking in public places.
Environmental tobacco smoke is a health hazard. Reducing exposure to tobacco smoke in public places is a widespread public health goal. There is, however, considerable variation in the extent to which this goal has been achieved in different settings and societies. There is therefore a need to identify effective strategies for reducing tobacco consumption in public places. ⋯ Carefully planned and resourced, multi-component strategies effectively reduced smoking within public places. Less comprehensive strategies were less effective. Most studies were done in the USA and, despite increasing evidence from Europe, there is a need to identify ways in which these strategies can be adopted and used in countries with different attitudes to tobacco use. Future studies should also consider the use of more rigorous experimental designs.