Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2009
ReviewWritten information about individual medicines for consumers.
Medicines are the most common intervention in most health services. As with all treatments, those taking medicines need sufficient information: to enable them to take and use the medicines effectively, to understand the potential harms and benefits, and to allow them to make an informed decision about taking them. Written medicines information, such as a leaflet or provided via the Internet, is an intervention that may meet these purposes. ⋯ The combined evidence was not strong enough to say whether written medicines information is effective in changing knowledge, attitudes and behaviours related to medicine taking. There is some evidence that written information can improve knowledge. The trials were generally of poor quality, which reduces confidence in the results. Trials examining the effects of written information need to be better designed and use consistent and validated outcome measures. Trials should evaluate internet-based medicines information. It is imperative that written medicines information be based on best practice for its information design and content, which could improve its effectiveness in helping people to use medicines appropriately.
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Cochrane Db Syst Rev · Apr 2009
Review Meta AnalysisIntravenous or intramuscular parecoxib for acute postoperative pain in adults.
Parecoxib was the first COX-2 available for parenteral administration, and may, given intravenously or intramuscularly, offer advantages over oral medication when patients have nausea and vomiting or are unable to swallow, such as in the immediate postoperative period. ⋯ A single dose of parecoxib 20 mg or 40 mg provided effective analgesia for 50 to 60% of those treated compared to about 15% with placebo, and was well tolerated. Duration of analgesia was longer, and significantly fewer participants required rescue medication over 24 hours with the higher dose.
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Cochrane Db Syst Rev · Apr 2009
Review Meta AnalysisHormone therapy in postmenopausal women and risk of endometrial hyperplasia.
Declining circulating estrogen levels around the time of the menopause can induce unacceptable symptoms that affect the health and well being of women. Hormone therapy (both unopposed estrogen and estrogen/progestogen combinations) is an effective treatment for these symptoms, but is associated with risk of harms. Guidelines recommend that hormone therapy be given at the lowest effective dose and treatment should be reviewed regularly. The aim of this review is to identify the minimum dose(s) of progestogen required to be added to estrogen so that the rate of endometrial hyperplasia is not increased compared to placebo. ⋯ Hormone therapy for postmenopausal women with an intact uterus should comprise both estrogen and progestogen to reduce the risk of endometrial hyperplasia.
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Cochrane Db Syst Rev · Apr 2009
Review Meta AnalysisInterventions for psychosexual dysfunction in women treated for gynaecological malignancy.
Psychosexual dysfunction (sexual difficulties not directly due to physical factors) is known to be a common complication of treatment for gynaecological cancer. It has a considerable impact on quality of life (QoL) for the increasing number of women who are survivors of gynaecological cancer. ⋯ There is no convincing evidence to support the use of any interventions for psychosexual dysfunction in women treated for gynaecological cancer. There is a need for more studies of high methodological quality.
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Cochrane Db Syst Rev · Apr 2009
Review Meta AnalysisProtein and energy supplementation in elderly people at risk from malnutrition.
Evidence for the effectiveness of nutritional supplements containing protein and energy, often prescribed for older people, is limited. Malnutrition is more common in this age group and deterioration of nutritional status can occur during illness. It is important to establish whether supplementing the diet is an effective way of improving outcomes for older people at risk from malnutrition. ⋯ Supplementation produces a small but consistent weight gain in older people. Mortality may be reduced in older people who are undernourished. There may also be a beneficial effect on complications which needs to be confirmed. However, this updated review found no evidence of improvement in functional benefit or reduction in length of hospital stay with supplements. Additional data from large-scale multi-centre trials are still required.