Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jul 2008
Review Meta AnalysisSurgical techniques for uterine incision and uterine closure at the time of caesarean section.
Caesarean section is a common operation. Techniques vary depending on both the clinical situation and the preferences of the operator. ⋯ While caesarean section is a common procedure performed on women worldwide, there is little information available to inform the most appropriate surgical technique to adopt.
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Cochrane Db Syst Rev · Jul 2008
Review Meta AnalysisOvulation triggers in anovulatory women undergoing ovulation induction.
Anovulation is a common cause for infertility. Drugs used to treat anovulation include selective estrogen receptor modulators, aromatase inhibitors and gonadotrophins. Ovulation triggers are used with these drugs, in order to time intercourse. Ovulation triggers without reliable evidence of oocyte maturity could be inappropriately timed, increase costs and psychological stress. This review evaluates different ovulation triggers used when treating anovulatory women with ovulation inducing agents compared to spontaneous ovulation. ⋯ There is inadequate evidence to recommend or refute the use of urinary hCG, as an ovulation trigger, in anovulatory women being treated with clomiphene citrate. We did not find trials evaluating the use of ovulation triggers in anovulatory women, being treated with other ovulation inducing agents.
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Many people with schizophrenia do not achieve a satisfactory treatment response with ordinary antipsychotic drug treatment. In these cases, various add-on medications are used; valproate is one of these. ⋯ Based on currently available randomised trial-derived evidence, there are no data to support or to refute valproate as a sole agent for schizophrenia. There is some evidence for positive effects on aggression and tardive dyskinesia, but given that these results were based on only a single small study they cannot be considered robust. Given the paucity of the available database further large, simple well-designed and reported trials are necessary. Ideally these would focus on people with schizophrenia and aggression, on those with treatment resistant forms of the disorder and on those with schizoaffective disorders.
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Cochrane Db Syst Rev · Jul 2008
Review Meta AnalysisAdjuvant therapy for completely resected stage II colon cancer.
Colon cancer is potentially curable by surgery. Although adjuvant chemotherapy benefits patients with stage III disease, there is uncertainty of such benefit in stage II colon cancer. A systematic review of the literature was performed to better define the potential benefits of adjuvant therapy for patients with stage II colon cancer. ⋯ Although there was no improvement in overall survival in the pooled analysis, we did find that disease-free survival in patients with stage II colon cancer was significantly better with the use of adjuvant therapy. It seems reasonable to discuss the benefits of adjuvant systemic chemotherapy with those stage II patients who have high risk features, including obstruction, perforation, inadequate lymph node sampling or T4 disease. The co-morbidities and likelihood of tolerating adjuvant systemic chemotherapy should be considered as well. There exists a need to further define which high-risk features in stage II colon cancer patients should be used to select patients for adjuvant therapy. Also, researchers must continue to search for other therapies which might be more effective, shorter in duration and less toxic than those available today.
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Cochrane Db Syst Rev · Jul 2008
Review Meta AnalysisAntibiotic duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women.
Urinary tract infections (UTI) are common in elderly patients. Authors of non systematic literature reviews often recommend longer treatment durations (7 to 14 days) for older women, but the evidence for such recommendations is unclear. ⋯ Short-course treatment (3 to 6 days) could be sufficient for treating uncomplicated UTIs in elderly women, although more studies on specific commonly prescribed antibiotics are needed.