Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Mar 2014
Review Meta AnalysisBisphosphonates for osteoporosis in people with cystic fibrosis.
Osteoporosis is a bone mineralisation disorder occurring in about one third of adults with cystic fibrosis. Bisphosphonates can increase bone mineral density and decrease the risk of new fractures in post-menopausal women and people receiving long-term oral corticosteroids. ⋯ Oral and intravenous bisphosphonates increase bone mineral density in people with cystic fibrosis. Severe bone pain and flu-like symptoms may occur with intravenous agents. Additional trials are needed to determine if bone pain is more common or severe (or both) with the more potent zoledronate and if corticosteroids ameliorate or prevent these adverse events. Additional trials are also required to further assess gastrointestinal adverse effects associated with oral bisphosphonates. Trials in larger populations are needed to determine effects on fracture rate and survival.
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Cochrane Db Syst Rev · Mar 2014
Review Meta AnalysisIntraperitoneal local anaesthetic instillation versus no intraperitoneal local anaesthetic instillation for laparoscopic cholecystectomy.
While laparoscopic cholecystectomy is generally considered less painful than open surgery, pain is one of the important reasons for delayed discharge after day surgery and overnight stay laparoscopic cholecystectomy. The safety and effectiveness of intraperitoneal local anaesthetic instillation in people undergoing laparoscopic cholecystectomy is unknown. ⋯ Serious adverse events were rare in studies evaluating local anaesthetic intraperitoneal instillation (very low quality evidence). There is very low quality evidence that it reduces pain in low anaesthetic risk people undergoing elective laparoscopic cholecystectomy. However, the clinical importance of this reduction in pain is unknown and likely to be small. Further randomised clinical trials of low risk of systematic and random errors are necessary. Such trials should include important clinical outcomes such as quality of life and time to return to work in their assessment.
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Cochrane Db Syst Rev · Mar 2014
Review Meta AnalysisWITHDRAWN: EMLA and Amethocaine for reduction of children's pain associated with needle insertion.
An update of this review was initiated by Janice A Lander1 and Barbara Brady‐Fryer2 in 2011, who proposed changing the title to "Three topical anaesthetics for reduction of children's pain associated with venipuncture and intravenous cannulation". At 23 May 2013, The Cochrane Pain, Palliative and Supportive Care Review Group (PaPaS) withdrew this review as the authors were no longer available to complete the update. 1Faculty of Nursing, University of Alberta, Edmonton, Canada 2Bachelor of Science in Nursing Program, Grant MacEwan University, Faculty of Health Sciences, Health and Community Studies, Edmonton, Canada The editorial group responsible for this previously published document have withdrawn it from publication.
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Cochrane Db Syst Rev · Mar 2014
Review Meta AnalysisWound infiltration with local anaesthetic agents for laparoscopic cholecystectomy.
While laparoscopic cholecystectomy is generally considered to be less painful than open surgery, pain is one of the important reasons for delayed discharge after day surgery resulting in overnight stay following laparoscopic cholecystectomy. The safety and effectiveness of local anaesthetic wound infiltration in people undergoing laparoscopic cholecystectomy is not known. ⋯ Serious adverse events were rare in studies evaluating local anaesthetic wound infiltration (very low quality evidence). There is very low quality evidence that infiltration reduces pain in low anaesthetic risk people undergoing elective laparoscopic cholecystectomy. However, the clinical importance of this reduction in pain is likely to be small. Further randomised clinical trials at low risk of systematic and random errors are necessary. Such trials should include important clinical outcomes such as quality of life and time to return to work in their assessment.
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Cochrane Db Syst Rev · Mar 2014
ReviewAuditory-verbal therapy for promoting spoken language development in children with permanent hearing impairments.
Congenital or early-acquired hearing impairment poses a major barrier to the development of spoken language and communication. Early detection and effective (re)habilitative interventions are essential for parents and families who wish their children to achieve age-appropriate spoken language. Auditory-verbal therapy (AVT) is a (re)habilitative approach aimed at children with hearing impairments. AVT comprises intensive early intervention therapy sessions with a focus on audition, technological management and involvement of the child's caregivers in therapy sessions; it is typically the only therapy approach used to specifically promote avoidance or exclusion of non-auditory facial communication. The primary goal of AVT is to achieve age-appropriate spoken language and for this to be used as the primary or sole method of communication. AVT programmes are expanding throughout the world; however, little evidence can be found on the effectiveness of the intervention. ⋯ This review confirms the lack of well-controlled studies addressing the use of AVT as an intervention for promoting spoken language development in children with permanent hearing impairments. Whilst lack of evidence does not necessarily imply lack of effect, it is at present not possible for conclusions to be drawn as to the effectiveness of this intervention in treating children with permanent hearing impairments.