Cochrane Db Syst Rev
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Eczema is a common skin disease in many countries, and although the majority of cases of eczema occur before the age of five years and often resolve during childhood or adolescence, it can also persist into adulthood. Itch is the most important aspect of eczema, often impacting significantly on the quality of life of an affected individual. ⋯ There is currently no high-level evidence to support or refute the efficacy or safety of oral H1 antihistamines used as monotherapy for eczema. Because most of the studies allowed the use of concomitant medications and involved multi-therapeutic approaches, meaningful assessments of the individual effects of oral H1 antihistamines on eczema were not feasible. Although well-designed randomised controlled trials excluding concomitant medications appear to be needed, consideration should be given to the potential ethical issues raised with the use of antihistamines as monotherapy for the management of eczema by withholding the use of rescue or additional therapies. A further systematic review of studies in which concomitant therapies were permitted might be of value in determining the potential benefits of oral H1 antihistamines as add-on therapy.
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Eczema is a common skin disease in many countries, and although the majority of cases of eczema occur before the age of five years and often resolve during childhood or adolescence, it can also persist into adulthood. Itch is the most important aspect of eczema, often impacting significantly on the quality of life of an affected individual. ⋯ There is currently no high-level evidence to support or refute the efficacy or safety of oral H1 antihistamines used as monotherapy for eczema. Because most of the studies allowed the use of concomitant medications and involved multi-therapeutic approaches, meaningful assessments of the individual effects of oral H1 antihistamines on eczema were not feasible. Although well-designed randomised controlled trials excluding concomitant medications appear to be needed, consideration should be given to the potential ethical issues raised with the use of antihistamines as monotherapy for the management of eczema by withholding the use of rescue or additional therapies. A further systematic review of studies in which concomitant therapies were permitted might be of value in determining the potential benefits of oral H1 antihistamines as add-on therapy.
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Cochrane Db Syst Rev · Feb 2013
Review Meta AnalysisColloids versus crystalloids for fluid resuscitation in critically ill patients.
Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid, and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids. ⋯ There is no evidence from randomised controlled trials that resuscitation with colloids reduces the risk of death, compared to resuscitation with crystalloids, in patients with trauma, burns or following surgery. Furthermore, the use of hydroxyethyl starch might increase mortality. As colloids are not associated with an improvement in survival and are considerably more expensive than crystalloids, it is hard to see how their continued use in clinical practice can be justified.
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Cochrane Db Syst Rev · Feb 2013
Review Meta AnalysisColloids versus crystalloids for fluid resuscitation in critically ill patients.
Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid, and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids. ⋯ There is no evidence from randomised controlled trials that resuscitation with colloids reduces the risk of death, compared to resuscitation with crystalloids, in patients with trauma, burns or following surgery. Furthermore, the use of hydroxyethyl starch might increase mortality. As colloids are not associated with an improvement in survival and are considerably more expensive than crystalloids, it is hard to see how their continued use in clinical practice can be justified.
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Cochrane Db Syst Rev · Feb 2013
Review Meta AnalysisExtramedullary fixation implants and external fixators for extracapsular hip fractures in adults.
Extramedullary fixation of hip fractures involves the application of a plate and screws to the lateral side of the proximal femur. In external fixators, the stabilising component is held outside the thigh by pins or screws driven into the bone. This is an update of a Cochrane review first published in 1998, and last updated in 2005. ⋯ The markedly increased fixation failure rate of fixed nail plates compared with the SHS is a major consideration and thus the SHS appears preferable.There was insufficient evidence from other comparisons of extramedullary implants or on the use of external fixators to draw definite conclusions.