Cochrane Db Syst Rev
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Acute spinal cord injury is a devastating condition typically affecting young people with a preponderance being male. Steroid treatment in the early hours of the injury is aimed at reducing the extent of permanent paralysis during the rest of the patient's life. ⋯ High dose methylprednisolone steroid therapy is the only pharmacological therapy shown to have efficacy in a Phase Three randomized trial when it can be administered within eight hours of injury. A recent trial indicates additional benefit by extending the maintenance dose from 24 to 48 hours if start of treatment must be delayed to between three and eight hours after injury. There is an urgent need for more randomized trials of pharmacological therapy for acute spinal cord injury.
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Many smokers give up smoking on their own, but materials giving advice and information may help them and increase the number who quit successfully. ⋯ Standard self-help materials may increase quit rates compared to no intervention, but the effect is likely to be small. We failed to find evidence that they have an additional benefit when used alongside other interventions such as advice from a health care professional, or nicotine replacement therapy. There is evidence that materials that are tailored for individual smokers are more effective.
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Each year about one million people die and about 10 million are seriously injured on the world's roads. Educational measures to teach pedestrians how to cope with the traffic environment are considered to be an essential component of any prevention strategy, and pedestrian education has been recommended in many countries. However, as resources available for road safety are limited, a key question concerns the relative effectiveness of different prevention strategies. ⋯ Pedestrian safety education can result in improvement in children's knowledge and can change observed road crossing behaviour but whether this reduces the risk of pedestrian motor vehicle collision and injury occurrence is unknown. There is evidence that changes in safety knowledge and observed behaviour decline with time suggesting that safety education must be repeated at regular intervals.
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Cochrane Db Syst Rev · Jan 2002
Review Meta AnalysisInterventions for replacing missing teeth: different types of dental implants.
Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant surface modifications have been developed for enhancing clinical performances. ⋯ There was no evidence that any of the implant systems evaluated was superior to the other. However, these findings are based on a few RCTs all having short follow-up periods and few participants. More RCTs should be conducted, with follow-up of at least five years and including a sufficient number of patients, to detect a true difference if any exists. Such trials should be reported according to the CONSORT guidelines (http://www.consort-statement.org/).
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Worldwide, carbamazepine and phenytoin are commonly used antiepileptic drugs. This review summarizes evidence from randomized controlled trials in which these two drugs have been compared. ⋯ We have not found evidence that a significant difference exists between carbamazepine and phenytoin for the outcomes examined in this review. Confidence intervals are wide and the possibility of important differences existing has not been excluded.