Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Oct 2009
Review Meta AnalysisHaemostatic drug therapies for acute spontaneous intracerebral haemorrhage.
Because spontaneous (non-traumatic) intracerebral haemorrhage (ICH) volume influences its outcome and a third of ICHs enlarge by a third within 24 hours of onset, early haemostatic drug therapy might improve outcome. This is an update of a Cochrane review first published in 2006. ⋯ Haemostatic drugs cannot be recommended for the treatment of acute spontaneous ICH in clinical practice, but a large RCT would be justified.
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Cochrane Db Syst Rev · Oct 2009
Review Meta AnalysisIntravenous oxytocin alone for cervical ripening and induction of labour.
Oxytocin is the commonest induction agent used worldwide. It has been used alone, in combination with amniotomy or following cervical ripening with other pharmacological or non-pharmacological methods. ⋯ Comparison of oxytocin with either intravaginal or intracervical PGE2 reveals that the prostaglandin agents probably increase the chances of achieving vaginal birth within 24 hours. Oxytocin induction may increase the rate of interventions in labour.A suggestion that for women with prelabour rupture of membranes induction with vaginal prostaglandin may increase risk of infection for mother and baby warrants further study.
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Cochrane Db Syst Rev · Oct 2009
Review Meta AnalysisMinimally invasive synthetic suburethral sling operations for stress urinary incontinence in women.
Stress urinary incontinence (SUI) is a common condition affecting up to 30% of women. Minimally invasive synthetic suburethral sling operations are among the latest forms of procedures introduced to treat SUI. ⋯ The current evidence base suggests that minimally invasive synthetic suburethral sling operations are as effective as traditional suburethral slings, open retropubic colposuspension and laparoscopic colposuspension in the short term but with less postoperative complications. Women were less likely to be continent after operations performed via the obturator (rather than retropubic) route, but they had fewer complications. Most of the trials had short term follow up and the quality of the evidence was variable.
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Cochrane Db Syst Rev · Oct 2009
Review Meta AnalysisChinese herbal medicines for esophageal cancer.
Esophageal cancer is the seventh leading cause of cancer death worldwide. Traditional Chinese herbal medicines are sometimes used as an adjunct to radiotherapy or chemotherapy for this type of cancer. ⋯ We were unable to find any evidence from RCTs on the effectiveness of TCM in the treatment of esophageal cancer. New trials should be carried out and we recommend that they are large scaled, correctly randomised and that the assessors of the results are blinded to the conditions of allocation.
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Cochrane Db Syst Rev · Oct 2009
Review Meta AnalysisThe impact of conditional cash transfers on health outcomes and use of health services in low and middle income countries.
Conditional cash transfers (CCT) provide monetary transfers to households on the condition that they comply with some pre-defined requirements. CCT programmes have been justified on the grounds that demand-side subsidies are necessary to address inequities in access to health and social services for poor people. In the past decade they have become increasingly popular, particularly in middle income countries in Latin America. ⋯ Conditional cash transfer programmes have been the subject of some well-designed evaluations, which strongly suggest that they could be an effective approach to improving access to preventive services. Their replicability under different conditions - particularly in more deprived settings - is still unclear because they depend on effective primary health care and mechanisms to disburse payments. Further rigorous evaluative research is needed, particularly where CCTs are being introduced in low income countries, for example in Sub-Saharan Africa or South Asia.