Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisTirilazad for aneurysmal subarachnoid haemorrhage.
Delayed cerebral ischaemia is a significant contributor to poor outcome (death or disability) in patients with aneurysmal subarachnoid haemorrhage (SAH). Tirilazad is considered to have neuroprotective properties in animal models of acute cerebral ischaemia. ⋯ There is no evidence that tirilazad, in addition to nimodipine, reduces mortality or improves poor outcome in patients with aneurysmal SAH.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisExercise based rehabilitation for heart failure.
From previous systematic reviews and meta-analyses there is consensus about the positive effect of exercise training on exercise capacity; however, the effects on health-related quality of life, mortality and hospital admissions in heart failure remain uncertain. ⋯ The previous version of this review showed that exercise training improved exercise capacity in the short term in patients with mild to moderate heart failure when compared to usual care. This updated review provides evidence that in a similar population of patients, exercise does not increase the risk of all-cause mortality and may reduce heart failure-related hospital admissions. Exercise training may offer important improvements in patients' health-related quality of life.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisOral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulation.
A number of basic research and clinical studies have led to the hypothesis that oral anticoagulants may improve the survival of patients with cancer through an antitumor effect in addition to their antithrombotic effect. ⋯ Existing evidence does not suggest a mortality benefit from oral anticoagulation in patients with cancer while increasing the risk for bleeding.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisInterventions to prevent hypothermia at birth in preterm and/or low birthweight infants.
Keeping vulnerable preterm infants warm is problematic even when recommended routine thermal care guidelines are followed in the delivery suite. ⋯ Plastic wraps or bags, plastic caps, SSC and transwarmer mattresses all keep preterm infants warmer leading to higher temperatures on admission to neonatal units and less hypothermia. However, the small numbers of infants and studies and the absence of long-term follow-up mean that firm recommendations for clinical practice cannot be given.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisInterventions to improve question formulation in professional practice and self-directed learning.
Formulating questions is fundamental to the daily life of a healthcare worker and is a defining characteristic of professional competence and meaningful learning. With high expectations for healthcare providers to remain up-to-date with current evidence and the movement towards formalizing reflective practice as part of physician revalidation, it is important that curricula developed for improving the ability to formulate well-constructed questions are based on the best evidence. ⋯ Evidence from our review suggests that interventions to increase the quality of questions formulated in practice produce mixed results at both short- (immediately following intervention), and moderate-term follow up (up to nine months), comparatively. Although three studies reported effectiveness estimates of an educational intervention for increasing the quality of question formulation within the short term, only one study examined the effectiveness in the longer term (one year) and revealed that search skills had eroded over time. Data suggests that sustainability of effects from educational interventions for question formulation are unknown.