Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2013
Review Meta AnalysisPressure-relieving interventions for treating diabetic foot ulcers.
Diabetes-related foot ulceration is a major contributor to morbidity in diabetes. Diabetic foot ulcers are partly a consequence of abnormal foot pressures and pressure relief is a widely used treatment for healing diabetes-related plantar foot ulcers, but the most effective method for healing is unclear. ⋯ Non-removable, pressure-relieving casts are more effective in healing diabetes related plantar foot ulcers than removable casts, or dressings alone. Non-removable devices, when combined with Achilles tendon lengthening were more successful in one forefoot ulcer study than the use of a non-removable cast alone.
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Cochrane Db Syst Rev · Jan 2013
Review Meta AnalysisNasal versus oral route for placing feeding tubes in preterm or low birth weight infants.
Enteral feeding tubes for preterm or low birth weight infants may be placed via either the nose or mouth. Nasal placement may compromise respiration. However, orally placed tubes may be more prone to displacement, local irritation, and vagal stimulation. ⋯ There are insufficient data available to inform practice. A large randomised controlled trial would be required to determine if the use of naso- versus oro-enteric feeding tubes affects feeding, growth and development, and the incidence of adverse events in preterm or low birth weight infants.
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Cochrane Db Syst Rev · Jan 2013
Review Meta AnalysisPerioperative fluid volume optimization following proximal femoral fracture.
Proximal femoral fracture (PFF) is a common orthopaedic emergency, affecting mainly elderly people at high risk of complications. Advanced methods for managing fluid therapy during treatment for PFF are available, but their role in reducing risk is unclear. ⋯ Three studies considering a total of 200 participants reveal an absence of evidence that fluid optimization strategies improve outcomes for participants undergoing surgery for PFF. Length of hospital stay may be improved, but lack of good quality data leaves uncertainty. Further research powered to test some of these outcomes is ongoing.
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Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth, the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the root canal. However, a significant number of dentists continue to prescribe antibiotics to stop the pain of irreversible pulpitis. ⋯ This systematic review which was based on one low powered small sample trial assessed as a low risk of bias, illustrates that there is insufficient evidence to determine whether antibiotics reduce pain or not compared to not having antibiotics. The results of this review confirm the necessity for further larger sample and methodologically sound trials that can provide additional evidence as to whether antibiotics, prescribed in the preoperative phase, can affect treatment outcomes for irreversible pulpitis.
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Cochrane Db Syst Rev · Jan 2013
ReviewChest physiotherapy compared to no chest physiotherapy for cystic fibrosis.
Chest physiotherapy is widely used in people with cystic fibrosis in order to clear mucus from the airways. ⋯ The results of this review show that airway clearance techniques have short-term effects in the terms of increasing mucus transport. No evidence was found on which to draw conclusions concerning the long-term effects.