Cochrane Db Syst Rev
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Diclofenac is commonly used for acute pain in children, but is not licensed for this indication in all age groups. ⋯ Diclofenac is an effective analgesic for perioperative acute pain in children. It causes similar types of serious adverse reactions in children as in adults, but these are rare. More research on optimum dosing and safety in asthmatic children is required.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisDietary interventions for rheumatoid arthritis.
The question of what potential benefits and harms are associated with certain dietary regimes used in rheumatoid arthritis is an important one for many patients and health care providers. ⋯ The effects of dietary manipulation, including vegetarian, Mediterranean, elemental and elimination diets, on rheumatoid arthritis are still uncertain due to the included studies being small, single trials with moderate to high risk of bias. Higher drop-out rates and weight loss in the groups with dietary manipulation indicate that potential adverse effects should not be ignored.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisWorkplace interventions for preventing work disability.
Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders. ⋯ As a result of the few available studies, no convincing conclusions can be formulated about the effectiveness of workplace interventions on work-related outcomes and health outcomes regardless of the type of work disability. The pooled data for the musculoskeletal disorders subgroup indicated that workplace interventions are effective in the reduction of sickness absence, but they are not effective in improving health outcomes. The evidence from the subgroup analysis on musculoskeletal disorders was rated as moderate-quality evidence. Unfortunately, conclusions cannot be drawn on the effectiveness of these interventions for mental health problems and other health conditions due to a lack of studies.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisEarly amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care.
Caesarean section rates are over 20% in many developed countries. The main diagnosis contributing to the high rate in nulliparae is dystocia or prolonged labour. The present review assesses the effects of a policy of early amniotomy with early oxytocin administration for the prevention of, or the therapy for, delay in labour progress. ⋯ In prevention trials, early intervention with amniotomy and oxytocin appears to be associated with a modest reduction in the rate of caesarean section over standard care.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisVirtual reality training for surgical trainees in laparoscopic surgery.
Surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time consuming, costly, and of variable effectiveness. Training using a virtual reality simulator is an option to supplement standard training. ⋯ Virtual reality training can supplement standard laparoscopic surgical training of apprenticeship and is at least as effective as video trainer training in supplementing standard laparoscopic training. Further research of better methodological quality and more patient-relevant outcomes are needed.