Cochrane Db Syst Rev
-
Cochrane Db Syst Rev · Jan 2015
Review Meta AnalysisHomeopathic Oscillococcinum® for preventing and treating influenza and influenza-like illness.
Influenza is a highly infectious viral disease that is particularly common in the winter months. Oscillococcinum® is a patented homeopathic medicine that is made from a 1% solution of wild duck heart and liver extract, which is then serially diluted 200 times with water and alcohol. ⋯ There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum®.
-
Cochrane Db Syst Rev · Jan 2015
ReviewScreening with urinary dipsticks for reducing morbidity and mortality.
Urinary dipsticks are sometimes used for screening asymptomatic people, and for case-finding among inpatients or outpatients who do not have genitourinary symptoms. Abnormalities identified on screening sometimes lead to additional investigations, which may identify serious disease, such as bladder cancer and chronic kidney disease (CKD). Urinary dipstick screening could improve prognoses due to earlier detection, but could also lead to unnecessary and potentially invasive follow-up testing and unnecessary treatment. ⋯ We found no evidence to assess the benefits and harms of screening with urinary dipsticks, which remain unknown.
-
Cochrane Db Syst Rev · Jan 2015
Review Meta AnalysisAntibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity.
Several studies have suggested that prophylactic antibiotics given during pregnancy improved maternal and perinatal outcomes, while others have shown no benefit and some have reported adverse effects. ⋯ Antibiotic prophylaxis did not reduce the risk of preterm prelabour rupture of membranes or preterm delivery (apart from in the subgroup of women with a previous preterm birth who had bacterial vaginosis). Antibiotic prophylaxis given during the second or third trimester of pregnancy reduced the risk of postpartum endometritis, preterm rupture of membranes and gonococcal infection when given routinely to all pregnant women. Substantial bias possibly exists in the review's results because of a high rate of loss to follow-up and the small numbers of studies included in each of our analyses. There is also insufficient evidence on possible harmful effects on the baby. Therefore, we conclude that there is not enough evidence to recommend the use of routine antibiotics during pregnancy to prevent infectious adverse effects on pregnancy outcomes.
-
Cochrane Db Syst Rev · Jan 2015
Review Meta AnalysisWorkplace interventions for reducing sitting at work.
The number of people working whilst seated at a desk keeps increasing worldwide. As sitting increases, occupational physical strain declines at the same time. This has contributed to increases in cardiovascular disease, obesity and diabetes. Therefore, reducing and breaking up the time that people spend sitting while at work is important for health. ⋯ At present there is very low quality evidence that sit-stand desks can reduce sitting time at work, but the effects of policy changes and information and counselling are inconsistent. There is a need for high quality cluster-randomised trials to assess the effects of different types of interventions on objectively measured sitting time. There are many ongoing trials that might change these conclusions in the near future.
-
Cochrane Db Syst Rev · Jan 2015
Review Meta AnalysisPercutaneous ethanol injection or percutaneous acetic acid injection for early hepatocellular carcinoma.
Hepatocellular carcinoma (HCC) is the fifth most common global cancer. When HCC is diagnosed early, interventions such as percutaneous ethanol injection (PEI), percutaneous acetic acid injection (PAI), or radiofrequency (thermal) ablation (RF(T)A) may have curative potential and represent less invasive alternatives to surgery. ⋯ PEI versus PAI did not differ significantly regarding benefits and harms in people with early HCC, but the two included trials had only a limited number of participants and one trial was judged a high risk of bias. Thus, the current evidence precludes us from making any firm conclusions.There was also insufficient evidence to determine whether PEI versus surgery (segmental liver resection) was more effective, because conclusions were based on a single randomised trial. While some data from this single trial suggested that PEI was safer, the high risk of bias and the lack of any confirmatory evidence make a reliable assessment impossible.We found no trials assessing PEI or PAI versus no intervention, best supportive care, or sham intervention.There is a need for more randomised clinical trials assessing interventions for people with early stage HCC. Such trials should be conducted with low risks of systematic errors and random errors.