Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisAerobic exercise training programmes for improving physical and psychosocial health in adults with Down syndrome.
Although physical fitness has been suggested to improve physical and psychosocial health for a variety of population profiles, there is a lack of information about the safety and effectiveness of aerobic exercise for adults with Down syndrome. ⋯ There is insufficient evidence to demonstrate that there is improvement in physical or psychosocial outcomes of aerobic exercise in adults with Down syndrome. Although evidence exists to support improvements in physiological and psychological aspects from strategies using mixed physical activity programmes, well-conducted research examining long-term physical outcomes, adverse effects, psychosocial outcomes and costs is required before informed practice decisions can be made.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisIncreased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children.
Written action plans providing guidance in the early treatment of asthma exacerbations have traditionally advocated doubling of inhaled corticosteroids (ICS) as one of the first steps in treatment. ⋯ There is very little evidence from trials in children. In adults with asthma on daily maintenance ICS, a self-initiated ICS increase to 1000 to 2000 mcg/day at the onset of an exacerbation is not associated with a statistically significant reduction in the risk of exacerbations requiring rescue oral corticosteroids. More research is needed to assess the effectiveness of increased ICS doses at the onset of asthma exacerbations (particularly in children).
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisAntimicrobial agents for treating uncomplicated urinary tract infection in women.
Acute uncomplicated lower urinary tract infection (UTI) is one of the most common problems for which young women seek medical attention. ⋯ No differences were observed between the classes of antimicrobials included in this review for the symptomatic cure of acute uncomplicated UTI. Fluoroquinolones proved more effective than beta-lactams for the short-term bacteriological outcome, probably with little clinical significance. Individualised treatment should take into consideration the predictable susceptibility of urinary pathogens in local areas, possible adverse events and resistance development, and patient preference.
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Cochrane Db Syst Rev · Jan 2010
ReviewSimple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men.
Strictures of the urethra are the commonest cause of obstructed micturition in younger men and frequently recur after initial treatment. Standard treatment comprises internal widening of the strictured area by simple dilatation or by telescope-guided internal cutting (optical urethrotomy), but these interventions are associated with a high failure rate requiring repeated treatment. The alternative option of open urethroplasty whereby the urethral lumen is permanently widened by removal or grafting of the strictured segment is less likely to fail but requires greater expertise. Improved choice of graft material and shortened hospital stay suggest urethroplasty may be under used. The extent and quality of evidence guiding treatment choice for this condition is uncertain. ⋯ There were insufficient data to determine which intervention is best for urethral stricture disease in terms of balancing efficacy, adverse effects and costs. Well designed, adequately powered multi-centre trials are needed to answer relevant clinical questions regarding treatment of men with urethral strictures.
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Cochrane Db Syst Rev · Jan 2010
ReviewEnteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy.
For many patients with head and neck cancer, oral nutrition will not provide adequate nourishment during treatment with radiotherapy or chemoradiotherapy due to the acute toxicity of treatment, obstruction caused by the tumour, or both. The optimal method of enteral feeding for this patient group has yet to be established. ⋯ There is not sufficient evidence to determine the optimal method of enteral feeding for patients with head and neck cancer receiving radiotherapy and/or chemoradiotherapy. Further trials of the two methods of enteral feeding, incorporating larger sample sizes, are required.