Cochrane Db Syst Rev
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Eclampsia, the occurrence of a convulsion in association with pre-eclampsia, remains a rare but serious complication of pregnancy. A number of different anticonvulsants are used to control eclamptic fits and to prevent further fits. ⋯ Magnesium sulphate appears to be substantially more effective than diazepam for treatment of eclampsia.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisAnticholinergic therapy for chronic asthma in children over two years of age.
In the intrinsic system of controlling airway calibre, the cholinergic (muscarinic) sympathetic nervous system has an important role. Anticholinergic, anti muscarinic bronchodilators such as ipratropium bromide are frequently used in the management of childhood airway disease. In asthma, ipratropium is a less potent bronchodilator than beta-2 adrenergic agents but it is known to be a useful adjunct to other therapies, particularly in status asthmaticus. What remains unclear is the role of anticholinergic drugs in the maintenance treatment of chronic asthma. ⋯ The present review summarises the best evidence available to date. Although there were some small beneficial findings in favour of anticholinergic therapy, there is insufficient data to support the use of anticholinergic drugs in the maintenance treatment of chronic asthma in children.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisGowning by attendants and visitors in newborn nurseries for prevention of neonatal morbidity and mortality.
Overgowns are widely used in newborn nurseries and neonatal intensive care units. It was thought that they may help to prevent the spread of nosocomial infection and serve as a reminder to staff and visitors to wash their hands before contacts with the infant. ⋯ The evidence from this systematic review and meta analysis does not demonstrate that overgowns are effective in limiting death, infection or bacterial colonisation in infants admitted to newborn nurseries.
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There is pre-clinical evidence, involving several animal species, suggesting that opioid peptides play a role in the physiopathology of shock (endotoxic, hypovolemic, cardiogenic, spinal, anaphylactic). Many case reports have suggested that naloxone (an opiate antagonist) might be an effective treatment for shock in humans, but others have not supported such a point of view. This controversy led us to undertake a meta-analysis of the available evidence on the efficacy of naloxone as a treatment measure of shock in humans. ⋯ Naloxone improves blood pressure, especially mean arterial blood pressure. However, the clinical usefulness of naloxone to treat shock remains to be determined, and additional randomized controlled trials are needed to assess its usefulness.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisSelenium supplementation to prevent short-term morbidity in preterm neonates.
Selenium is an essential trace element and component of a number of selenoproteins including glutathione peroxidase, which has a role in protecting against oxidative damage. Selenium is also known to play a role in immunocompetence. Blood selenium concentrations in newborns are lower than those of their mothers and lower still in preterm infants. In experimental animals low selenium concentrations appear to increase susceptibility to oxidative lung disease. In very preterm infants low selenium concentrations have been associated with an increased risk of chronic neonatal lung disease and retinopathy of prematurity. ⋯ Supplementing very preterm infants with selenium is associated with benefit in terms of a reduction in one or more episodes of sepsis. Supplementation was not associated with improved survival, a reduction in neonatal chronic lung disease or retinopathy of prematurity. Supplemental doses of selenium for infants on parenteral nutrition higher than those currently recommended may be beneficial. The data are dominated by one large trial from a country with low selenium concentrations and may not be readily translated to other populations.