Cochrane Db Syst Rev
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Chronic wounds mainly affect the elderly and those with multiple health problems. Despite the use of modern dressings, some of these wounds take a long time to heal, fail to heal, or recur, causing significant pain and discomfort to the person and cost to health services. Topical negative pressure is used to promote healing of surgical wounds by using suction to drain excess fluid from wounds. ⋯ The two small trials provide weak evidence suggesting that TNP may be superior to saline gauze dressings in healing chronic human wounds. However, due to the small sample sizes and methodological limitations of these trials, the findings must be interpreted with extreme caution. The effect of TNP on cost, quality of life, pain and comfort was not reported. It was not possible to determine which was the optimum TNP regimen.
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Cochrane Db Syst Rev · Jan 2001
ReviewTroleandomycin as an oral corticosteroid steroid sparing agent in stable asthma.
Patients with chronic severe asthma are often dependent on the long term prescription of oral corticosteroids. The use of steroids is associated with serious side effects. Physicians treating such patients continue to search for alternative therapies that reduce the need for chronic dosing with oral steroids. troleandomycin is a compound that is established as an effective antibiotic but may also have non antibacterial actions that may be useful in the treatment of asthma. ⋯ There is insufficient evidence to support the use of troleandomycin in the treatment of steroid dependent asthma.
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Cochrane Db Syst Rev · Jan 2001
ReviewOral immunoglobulin for preventing necrotizing enterocolitis in preterm and low birth-weight neonates.
Necrotizing enterocolitis (NEC) is the most common emergency of the gastrointestinal tract occurring in the neonatal period. There have been published reports which suggest that oral immunoglobulins IgA and IgG produce an immunoprotective effect in the gastrointestinal mucosa. This systematic review was undertaken to clarify the issue. ⋯ Based on the available trials, the evidence does not support the administration of oral immunoglobulin for the prevention of NEC. There are no randomised controlled trials of oral IgA alone for the prevention of NEC.
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Cochrane Db Syst Rev · Jan 2001
ReviewColchicine for alcoholic and non-alcoholic liver fibrosis and cirrhosis.
The majority of liver fibrosis and liver cirrhosis cases in the Western World is caused by alcohol and hepatotoxic viruses. Colchicine is an anti-inflammatory and anti-fibrotic medication. Several randomised clinical trials have addressed the question whether colchicine has any efficacy in patients with alcoholic as well as non-alcoholic fibrosis and cirrhosis. ⋯ Colchicine should not be used for alcoholic, viral, or cryptogenic liver fibrosis or liver cirrhosis outside randomised trials.
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Cochrane Db Syst Rev · Jan 2001
ReviewAntibiotics for spontaneous bacterial peritonitis in cirrhotics.
Spontaneous bacterial peritonitis is mainly a complication of cirrhotic ascites that occurs in the absence of any intra-abdominal, surgically treatable source of infection. Antibiotics have been recommended as the mainstay treatment for spontaneous bacterial peritonitis. However, this recommendation is not based on convincing evidence. It has been proposed that treatment should cover Gram-negative enteric bacteria and Gram-positive cocci, that are responsible for up to 90% of cases. ⋯ This review provides no clear evidence for the treatment of cirrhotic patients with spontaneous bacterial peritonitis. Until large, well-conducted, trials provide adequate evidence, treatment must be based on clinical experience.