Cochrane Db Syst Rev
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To assess the effects of providing pregnant women with isocaloric protein supplements (ie where the protein replaces an equal quantity of nonprotein energy) on gestational weight gain and on the outcome of pregnancy. ⋯ Balanced protein supplementation alone (ie without energy supplementation) is unlikely to be of benefit to pregnant women or their infants.
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Cochrane Db Syst Rev · Jan 2000
ReviewGonadotropin releasing hormone agonist protocols for pituitary desensitization in in vitro fertilization and gamete intrafallopian transfer cycles.
Gonadotropin releasing hormone agonists (GnRHa) are used in assisted reproduction cycles to reversibly block pituitary function and prevent a luteinizing hormone surge. In the short and ultrashort protocols of GnRHa administration, injection of gonadotropins is commenced a few days after the start of GnRHa. In the long protocols (with GnRHa started either in the midluteal phase or in the early follicular phase) gonadotropin administration is delayed until pituitary desensitization has been achieved, usually 2-3 weeks. ⋯ On the basis of clinical pregnancy rate per cycle started, this meta-analysis demonstrates the superiority of the long protocol over the short and ultrashort protocols for GnRHa use in IVF and GIFT cycles.
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Around 120 million women worldwide suffer from Trichomonas vaginalis vaginitis every year. The infection is sexually transmitted and is believed to facilitate HIV transmission. The objective of the review is to assess the effects of various treatment strategies for trichomoniasis in women. ⋯ Parasitological cure can be achieved by single oral dose of nitroimidazoles. Further research should focus on developing effective partner treatment strategies to prevent re-infections and reduce trichomoniasis prevalence.
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Cochrane Db Syst Rev · Jan 2000
ReviewExtubation from low-rate intermittent positive airways pressure versus extubation after a trial of endotracheal continuous positive airways pressure in intubated preterm infants.
Failure of extubation and subsequent reintubation may result in additional stress and trauma to the premature infant. Testing infants about to be extubated with a period of endotracheal CPAP has been suggested as a method of demonstrating readiness for extubation. However, this process has been criticized as increasing the neonate's work of breathing and perhaps increasing the likelihood of extubation failure. ⋯ Preterm infants no longer requiring endotracheal intubation and IPPV should be directly extubated without a trial of ETT CPAP.
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Cochrane Db Syst Rev · Jan 2000
ReviewAudit and feedback versus alternative strategies: effects on professional practice and health care outcomes.
Audit and feedback has been identified as having the potential to change the practice of health care professionals. ⋯ It is not possible to recommend a complementary intervention to enhance the effectiveness of audit and feedback. Reminders might be more effective than audit and feedback to improve the delivery of some preventive services but the results are not striking. Few trials have investigated the effect of varying different characteristics of the audit and feedback process. Consideration should be given to testing the effects of modifying important characteristics such as the content, source, timing, recipient and format.