Cochrane Db Syst Rev
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Huperzine A, a form of herbal medicine, has been considered as an alternative treatment for vascular dementia (VaD) in China. ⋯ There is no [convincing] evidence that Huperzine A is of value in vascular dementia based on one small trial. It deserves further research.
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Chronic non-specific cough is a chronic, dry cough of in the absence of identifiable respiratory disease or known aetiology. Although it is usually not reflective of an underlying severe illness, it does cause significant morbidity, and as such relief from it is often sought. The use of honey and lozenges to soothe upper respiratory tract irritation is common, inexpensive, and potentially more effective in treating the symptoms than pharmacological interventions. ⋯ Clinically, this review was unable to provide any justifiable recommendation for or against honey and/or lozenges due to the lack of evidence. The absence of applicable studies highlights the need for further research into the area of treating children with chronic non-specific coughs with honey and/or lozenges. These treatments are not recommended when managing very young children (as lozenges are a potential choking hazard, and honey may cause infant botulism in children under 1 year of age).
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Cochrane Db Syst Rev · Apr 2009
Review Meta AnalysisOsteotomy, compression and other modifications of surgical techniques for internal fixation of extracapsular hip fractures.
Many different surgical techniques have been described for the internal fixation of extracapsular hip fractures. ⋯ There is inadequate evidence to support the use of osteotomy for internal fixation of a trochanteric hip fracture. Similarly, there is insufficient evidence to support the use of the other techniques examined in the trials included in this review.
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Cochrane Db Syst Rev · Apr 2009
Review Meta AnalysisPain control in first trimester surgical abortion.
First trimester abortions especially cervical dilation and suction aspiration are associated with pain, despite various methods of pain control. ⋯ Conscious sedation, GA and some non-pharmacological interventions decreased procedural and postoperative pain, while being safe and satisfactory to patients. Data on the widely used PCB is inadequate to support its use, and it needs to be further studied to determine any benefit.
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Cochrane Db Syst Rev · Apr 2009
ReviewWITHDRAWN: Interventions for treating hallux valgus (abductovalgus) and bunions.
Hallux valgus is classified as an abnormal deviation of the great toe (hallux) towards the midline of the foot. ⋯ Only a few studies had considered conservative treatments. The evidence from these suggested that orthoses and night splints did not appear to be any more beneficial in improving outcomes than no treatment. Surgery (chevron osteotomy) was shown to be beneficial compared to orthoses or no treatment, but when compared to other osteotomies, no technique was shown to be superior to any other. Only one trial had compared an osteotomy to an arthroplasty. There was limited evidence to suggest that the osteotomy gave the better outcomes. It was notable that the numbers of participants in some trials remaining dissatisfied at follow-up were consistently high (25 to 33%), even when the hallux valgus angle and pain had improved. A few of the more recent trials used assessment scores that combine several aspects of the patients outcomes. These scoring systems are useful to the clinician when comparing techniques but are of dubious relevance to the patient if they do not address their main concern and such scoring systems are frequently unvalidated. Only one study simply asked the patient if they were better than before the treatment. Final outcomes were most frequently measured at one year, with a few trials maintaining follow-up for 3 years. Such time-scales are minimal given that the patients will be on their feet for at least another 20-30 years after treatment. Future research should include patient-focused outcomes, standardised assessment criteria and longer surveillance periods, more usefully in the region of 5-10 years.