Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewInhaled short acting beta2-agonist use in asthma: regular vs as needed treatment.
Inhaled beta2-adrenergic agonists delivered by inhalation are very widely used in asthma. There has been much controversy of the use and possible consequences of the use of these agents for regular, as opposed as-needed use in asthma. ⋯ These results support current guidelines. There is little advantage in using short-acting beta2-agonists regularly, and potentially some small clinical disadvantage.
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Cochrane Db Syst Rev · Jan 2000
ReviewEarly amniocentesis versus transabdominal chorion villus sampling for prenatal diagnosis.
A major disadvantage of amniocentesis is that test results are usually available only after 18 weeks gestation. Early amniocentesis can now be done between 9 to 14 weeks gestation. ⋯ Current data suggest that early amniocentesis is associated with a greater risk of spontaneous miscarriage and neonatal talipes compared to transabdominal chorion villus sampling. An increased risk of these complications needs to be weighed against fewer technical difficulties and the possibility of fewer neonatal haemangiomas.
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This review has been withdrawn because it is out of date. The topic will be covered by a new review, 'The effect of the timing of feedings on the establishment of breastfeeding', the protocol for which is currently being prepared. ⋯ No differences were found between early and delayed contact in regard to breastfeeding duration. Early contact was associated with greater communication between mothers and infants.
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Cochrane Db Syst Rev · Jan 2000
ReviewMaternal antigen avoidance during lactation for preventing atopic disease in infants of women at high risk.
To assess the effects of prescribing an antigen avoidance diet during lactation on the nutritional status of the mother and newborn and on the development of atopic disease in the child. The main focus is on women whose infants are at high risk for developing an atopic condition, based on a history of atopic disease in the mother, father, or a previous child. ⋯ Prescription of an antigen avoidance diet to a high-risk woman during lactation may substantially reduce her child's risk of developing atopic eczema, but better trials are needed.
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Oligo-astheno-teratospermia (sperm of low concentration, reduced motility and increased abnormal morphology) of unknown cause is common and the need for treatment is felt by patients and doctors alike. As a result, a variety of empirical, non-specific treatments have been used in an attempt to improve semen characteristics and fertility. The administration of anti-oestrogens is a common treatment because anti oestrogens interfere with the normal negative feedback of sex steroids at hypothalamic and pituitary levels in order to increase endogenous gonadotropin-releasing hormone secretion from the hypothalamus and FSH and LH secretion directly from the pituitary. In turn, FSH and LH stimulate Leydig cells in the testes, and this has been claimed to lead to increased local testosterone production, thereby boosting spermatogenesis with a possible improvement in fertility. There may also be a direct effect of anti-oestrogens on testicular spermatogenesis or steroidogenesis. This review considers the available evidence of the effect of both Clomiphene citrate and tamoxifen, both of which have a predominant anti-oestrogenic effect, for idiopathic oligo and/or asthenospermia. ⋯ Anti-oestrogens appear to have a beneficial effect on endocrinal outcomes, but there is not enough evidence to evaluate the use of anti-oestrogens for increasing the fertility of males with idiopathic oligo-asthenospermia.