Cochrane Db Syst Rev
-
People with cystic fibrosis and pancreatic insufficiency are at risk of fat soluble vitamin deficiency as these vitamins (A, D, E and K) are co-absorbed with fat. Thus, some cystic fibrosis centres routinely administer these vitamins as supplements but the centres vary in their approach of addressing the possible development of deficiencies in these vitamins. Vitamin A deficiency causes predominantly eye and skin problems while supplementation of vitamin A to excessive levels may cause harm to the respiratory and skeletal systems in children. Thus a systematic review on vitamin A supplementation in people with cystic fibrosis would help guide clinical practice. ⋯ As there were no randomised or quasi-randomised controlled trials identified, we cannot draw any conclusions on the benefits (or otherwise) of regular administration of vitamin A in people with cystic fibrosis. Until further data are available, country or region specific guidelines on the use of vitamin A in people with cystic fibrosis should be followed.
-
Cochrane Db Syst Rev · May 2014
Review Meta AnalysisFemoral nerve blocks for acute postoperative pain after knee replacement surgery.
Femoral nerve block is better than PCA alone after total knee replacement, although comparison to local infiltration is unclear.
pearl -
For most patients who require intensive care, the success of clinical decision making and interventions is dependent on the accuracy of different physiological variables measured or obtained from samples using an arterial catheter. Maintaining the patency of these catheters is therefore essential for obtaining accurate measures, minimizing patient discomfort and reducing expenses incurred when an occluded catheter requires replacement. Uncertainty exists amongst clinicians as to best practice surrounding the contents of the arterial catheter flush solution (heparin or saline). The use of heparin is more expensive and is accompanied by significant risks such as haemorrhage, hypersensitivity and heparin-induced thrombocytopenia (HIT). ⋯ The available evidence is of poor quality because of risk of bias and does not provide sufficient information to support the effects of adding heparin (1 to 2 IU/mL) to a maintenance solution (pressurized to deliver 3 mL of flush solution per hour) of 0.9% normal saline in maintaining the patency and functionality of arterial catheters.
-
Cochrane Db Syst Rev · May 2014
Review Meta AnalysisInterventions for replacing missing teeth: augmentation procedures of the maxillary sinus.
Insufficient bone volume is a common problem encountered in the rehabilitation of the edentulous posterior maxillae with implant-supported prostheses. Bone volume is limited by the presence of the maxillary sinus together with loss of alveolar bone height. Sinus lift procedures increase bone volume by augmenting the sinus cavity with autogenous bone or commercially available biomaterials, or both. This is an update of a Cochrane review first published in 2010. ⋯ There is moderate quality evidence which is insufficient to determine whether sinus lift procedures in bone with residual height between 4 and 9 mm are more or less successful than placing short implants (5 to 8.5 mm) in reducing prosthesis or implant failure up to one year after loading. However, there are more complications at sites treated with sinus lift procedures. Many trials compared different sinus lift procedures and none of these indicated that one procedure reduced prosthetic or implant failures when compared to the other. Based on low quality evidence, patients may prefer rotary instruments over hand malleting for crestal sinus lift.
-
Cochrane Db Syst Rev · May 2014
Review Meta AnalysisYoga for the primary prevention of cardiovascular disease.
A sedentary lifestyle and stress are major risk factors for cardiovascular disease (CVD). Since yoga involves exercise and is thought to help in stress reduction it may be an effective strategy in the primary prevention of CVD. ⋯ The limited evidence comes from small, short-term, low-quality studies. There is some evidence that yoga has favourable effects on diastolic blood pressure, HDL cholesterol and triglycerides, and uncertain effects on LDL cholesterol. These results should be considered as exploratory and interpreted with caution.