Cochrane Db Syst Rev
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Cardiotocography is a form of fetal assessment which simultaneously records fetal heart rate, fetal movements and uterine contractions to investigate hypoxia. ⋯ There is not enough evidence to evaluate the use of antenatal cardiotocography for fetal assessment. All of the trials included in this review date from the introduction of antenatal cardiotocography and may be difficult to relate to current practice.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisPhysical conditioning programs for improving work outcomes in workers with back pain.
Physical conditioning programs aim to improve work status for workers on sick leave. This is an update of a Cochrane Review (Work conditioning, work hardening and functional restoration for workers with back and neck pain) first published in 2003. ⋯ The effectiveness of physical conditioning programs in reducing sick leave when compared to usual care or than other exercises in workers with back pain remains uncertain. In workers with acute back pain, these programs probably have no effect on sick leave, but there may be a positive effect on sick leave for workers with subacute and chronic back pain. Workplace involvement might improve the outcome. Better understanding of the mechanism behind physical conditioning programs and return-to-work is needed to be able to develop more effective interventions.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisBenzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults.
Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. However, the evidence for their use for this symptom is unclear. ⋯ There is no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in patients with advanced cancer and COPD. There is a slight but non-significant trend towards a beneficial effect but the overall effect size is small. Benzodiazepines caused more drowsiness as an adverse effect compared to placebo, but less compared to morphine. These results justify considering benzodiazepines as a second or third-line treatment within an individual therapeutic trial, when opioids and non-pharmacological measures have failed to control breathlessness. Although a few good quality studies were included in this review, there is still a further need for well-conducted and adequately powered studies.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisAntibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section.
The single most important risk factor for postpartum maternal infection is cesarean section. Routine prophylaxis with antibiotics may reduce this risk and should be assessed in terms of benefits and harms. ⋯ Endometritis was reduced by two thirds to three quarters and a decrease in wound infection was also identified. However, there was incomplete information collected about potential adverse effects, including the effect of antibiotics on the baby, making the assessment of overall benefits and harms complicated. Prophylactic antibiotics given to all women undergoing elective or non-elective cesarean section is clearly beneficial for women but there is uncertainty about the consequences for the baby.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisNutritional supplementation for hip fracture aftercare in older people.
Older people with hip fractures are often malnourished at the time of fracture, and have poor food intake subsequently. ⋯ Weak evidence exists for the effectiveness of protein and energy feeds. Adequately sized randomised trials with robust methodology are required. In particular, the role of dietetic assistants, and peripheral venous feeding require further evaluation.