Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2012
Review Meta AnalysisSingle dose oral etoricoxib for acute postoperative pain in adults.
Etoricoxib is a selective cyclo-oxygenase-2 (COX-2) inhibitor licensed for the relief of chronic pain in osteoarthritis and rheumatoid arthritis, and acute pain in some jurisdictions. This class of drugs is believed to be associated with fewer upper gastrointestinal adverse effects than conventional non-steroidal anti-inflammatory drugs (NSAIDs). One additional study in acute postoperative pain has been published since the original review was completed in Issue 2, 2009. ⋯ The additional study did not change the results from the first review published in 2009, but does make the result more robust. Single dose oral etoricoxib produces high levels of good quality pain relief after surgery and adverse events did not differ from placebo. The 120 mg dose is as effective as, or better than, other commonly used analgesics.
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Cochrane Db Syst Rev · Apr 2012
Review Meta AnalysisAnticholinergic therapy for acute asthma in children.
Inhaled anticholinergics as single agent bronchodilators (or in combination with beta(2)-agonists) are one of the several medications available for the treatment of acute asthma in children. ⋯ In children over the age of two years with acute asthma exacerbations, inhaled anticholinergics as single agent bronchodilators were less efficacious than beta(2)-agonists. Inhaled anticholinergics were also less efficacious than inhaled anticholinergics combined with beta(2)-agonists. Inhaled anticholinergic drugs alone are not appropriate for use as a single agent in children with acute asthma exacerbations.
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Cochrane Db Syst Rev · Apr 2012
Review Meta AnalysisHome care by outreach nursing for chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is characterised by progressive airflow obstruction, worsening exercise performance and health deterioration. It is associated with significant morbidity, mortality and health system burden. ⋯ Outreach nursing programmes for COPD improved disease-specific HRQL. However the effect on hospitalisations was heterogeneous, reducing admissions in one study, but increasing them in others, therefore we could not draw firm conclusions for this outcome.
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Cochrane Db Syst Rev · Apr 2012
Review Meta AnalysisInterventions for restoring patency of occluded central venous catheter lumens.
Central venous catheters (CVCs) facilitate the administration of intravenous drugs, fluids, blood products and parenteral nutrition to patients with either chronic disease or critical illness. Despite a pivotal role within medical management, a common complication associated with CVC use is occlusion of the CVC lumen(s). CVC occlusion can interrupt and cause serious delays in administration of treatment interventions. ⋯ There is inadequate evidence to draw strong conclusions on the efficacy or safety of the drug interventions included in this review. There is some low quality evidence from a meta-analysis of two studies investigating urokinase (various strengths) and some very low evidence from two single studies investigating alteplase 2 mg/2 mL that suggest that these two drug interventions may be effective in treating withdrawal or total occlusion of CVC lumens caused by thrombosis. Further high quality, sufficiently powered research is still required to look at the efficacy and safety of urokinase, alteplase and other chemical, surgical and drug interventions for treating CVC lumen occlusion. Research studies which exclusively include child participants are especially warranted.
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Cochrane Db Syst Rev · Apr 2012
Review Meta AnalysisInterventions for preventing excessive weight gain during pregnancy.
Excessive weight gain during pregnancy is associated with multiple maternal and neonatal complications. However, interventions to prevent excessive weight gain during pregnancy have not been adequately evaluated. ⋯ There is not enough evidence to recommend any intervention for preventing excessive weight gain during pregnancy, due to the significant methodological limitations of included studies and the small observed effect sizes. More high-quality randomised controlled trials with adequate sample sizes are required to evaluate the effectiveness of potential interventions.