Cochrane Db Syst Rev
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Overweight and obesity are global health problems contributing to an ever increasing noncommunicable disease burden. Calorie restriction can achieve short-term weight loss but the weight loss has not been shown to be sustainable in the long-term. An alternative approach to calorie restriction is to lower the fat content of the diet. However, the long-term effects of fat-restricted diets on weight loss have not been established. ⋯ The review suggests that fat-restricted diets are no better than calorie restricted diets in achieving long term weight loss in overweight or obese people. Overall, participants lost slightly more weight on the control diets but this was not significantly different from the weight loss achieved through dietary fat restriction and was so small as to be clinically insignificant.
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Cochrane Db Syst Rev · Jan 2002
ReviewEmergency sclerotherapy versus medical interventions for bleeding oesophageal varices in cirrhotic patients.
Emergency sclerotherapy is widely used as a first line therapy for variceal bleeding in cirrhosis, although pharmacological treatment may stop bleeding in the majority of patients. ⋯ We found no convincing evidence to support the use of emergency sclerotherapy for variceal bleeding in cirrhosis as the first, single treatment when compared with vasoactive drugs.
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Cochrane Db Syst Rev · Jan 2002
ReviewFluoride gels for preventing dental caries in children and adolescents.
Topically applied fluoride gels have been widely used as a caries-preventive intervention in dental surgeries and school-based programs for over two decades. ⋯ There is clear evidence of a caries-inhibiting effect of fluoride gel. The best estimate of the magnitude of this effect, based on the 14 placebo-controlled trials, is a 21% reduction (95% CI, 14 to 28%) in D(M)FS. This corresponds to an NNT of 2 (95% CI, 1 to 3) to avoid 1 D(M)FS in a population with a caries increment of 2.2 D(M)FS/year, or an NNT of 24 (95% CI, 18 to 36) based on an increment of 0.2 D(M)FS/year. There is little information concerning deciduous dentition, on adverse effects or on acceptability of treatment. Future trials should include assessment of potential adverse effects.
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Primary repair of penetrating colon injuries is an appealing management option, however uncertainty about its safety persists. ⋯ Meta-analysis of currently published randomized controlled trials favors primary repair over fecal diversion for penetrating colon injuries.
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The treatment of schizophrenia with old, 'typical' antipsychotic drugs such as haloperidol can be problematic, because many people treated with these drugs will suffer from movement disorders. Amisulpride is said to be an "atypical" antipsychotic which induces less movement disorder and which is effective for the negative symptoms of schizophrenia. ⋯ This systematic review confirms that amisulpride is an effective 'atypical' antipsychotic drug for those with schizophrenia. Amisulpride may offer a good general profile, at least compared to high-potency 'typical' antipsychotics. It may also yield better results in some specific outcomes related to efficacy, such as improvement of global state and general negative symptoms. It might be more acceptable and more tolerable than high-potency conventional antipsychotics, especially regarding extrapyramidal side-effects. Longer term randomised trials are needed to evaluate the comparative value of amisulpride, particularly compared to other expensive atypical antipsychotics. These should focus on important outcomes which have not been sufficiently monitored such as service use, family burden and quality of life.