Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2012
ReviewAntibiotic treatment for nontuberculous mycobacteria lung infection in people with cystic fibrosis.
Nontuberculous mycobacteria are mycobacteria, other than those in the Mycobacterium tuberculosis complex, and are commonly found in the environment. Nontuberculous mycobacteria species (most commonly Mycobacterium avium complex and Mycobacterium abscessus) are isolated from the respiratory tract of approximately 5% to 20% of individuals with cystic fibrosis; they can cause lung disease in people with cystic fibrosis leading to more a rapid decline in lung function and even death in certain circumstances. Although there are guidelines for the antimicrobial treatment of nontuberculous mycobacteria lung disease, these recommendations are not specific for people with cystic fibrosis and it is not clear which antibiotic regimen may be the most effective in the treatment of these patients. ⋯ This review did not find any evidence for the effectiveness of different antimicrobial treatment for nontuberculous mycobacteria lung disease in people with cystic fibrosis. Until such evidence becomes available, it is reasonable for clinicians to follow the American Thoracic Society guidelines for the diagnosis and treatment of nodular or bronchiectatic pulmonary disease due to Mycobacterium avium complex or Mycobacterium abscessus in patients with cystic fibrosis.
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Cochrane Db Syst Rev · Jan 2012
ReviewPulmonary artery flow catheters for directing management in pre-eclampsia.
Gestational hypertension and pre-eclampsia can cause fluid shifts. Pulmonary oedema and renal failure can result from these shifts. Fluid management is crucial in managing pre-eclampsia, especially in the context of pulmonary oedema and renal failure. Pulmonary artery catheterisation may be a method of effectively monitoring fluid status and thus aid in the management of renal failure and pulmonary oedema in the context of pre-eclampsia. ⋯ There is currently no evidence from randomised controlled trials supporting the use of the pulmonary artery catheters. Fluid management in pre-eclampsia, especially in the context of preventing or managing renal failure and pulmonary oedema, remains an important issue. Randomised trials dealing with this intervention are needed, however, we do recognise the difficulty in performing randomised trials due to the invasive nature of the procedure and skills involved in inserting a pulmonary flow catheter.
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Cochrane Db Syst Rev · Jan 2012
Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases.
This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective is to determine the effectiveness of i) advice to increase fruit and vegetable consumption ii) the provision of fruit and vegetables to increase consumption, for the primary prevention of CVD.
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Acute spinal cord injury is a devastating condition typically affecting young people, mostly males. Steroid treatment in the early hours after the injury is aimed at reducing the extent of permanent paralysis during the rest of the patient's life. ⋯ High-dose methylprednisolone steroid therapy is the only pharmacologic therapy shown to have efficacy in a phase three randomized trial when administered within eight hours of injury. One trial indicates additional benefit by extending the maintenance dose from 24 to 48 hours, if start of treatment must be delayed to between three and eight hours after injury. There is an urgent need for more randomized trials of pharmacologic therapy for acute spinal cord injury.
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Cochrane Db Syst Rev · Jan 2012
Review Meta AnalysisEmail for clinical communication between patients/caregivers and healthcare professionals.
Email is a popular and commonly-used method of communication, but its use in health care is not routine. Where email communication has been demonstrated in health care this has included its use for communication between patients/caregivers and healthcare professionals for clinical purposes, but the effects of using email in this way is not known.This review addresses the use of email for two-way clinical communication between patients/caregivers and healthcare professionals. ⋯ The evidence base was found to be limited with variable results and missing data, and therefore it was not possible to adequately assess the effect of email for clinical communication between patients/caregivers and healthcare professionals. Recommendations for clinical practice could not be made. Future research should ideally address the issue of missing data and methodological concerns by adhering to published reporting standards. The rapidly changing nature of technology should be taken into account when designing and conducting future studies and barriers to trial development and implementation should also be tackled. Potential outcomes of interest for future research include cost-effectiveness and health service resource use.