Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewAnti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma.
Inhaled corticosteroids are the cornerstone of anti-inflammatory asthma treatment. Anti-leukotrienes agents are currently being studied as alternative first line agents in the management of mild to moderate chronic asthma. ⋯ Anti-leukotriene agents had a similar rate of exacerbations compared to inhaled corticosteroids, but inhaled steroids produced better lung function and quality of life as well as reduced symptoms, night awakenings and need for rescue beta2-agonist. Reliable conclusions cannot yet be drawn regarding the efficacy of this treatment due to the paucity of trials published in full text.
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Cochrane Db Syst Rev · Jan 2000
ReviewSingle dose oxycodone and oxycodone plus paracetamol (acetominophen) for acute postoperative pain.
Oxycodone is a strong opioid agonist which is useful for the management of severe pain. It is becoming increasingly important to assess the relative efficacy and harm caused by different treatments. This can be determined when an analgesic is compared with control under similar clinical circumstances. ⋯ Single-dose oral oxycodone, with or without paracetamol, appears to be of comparable efficacy to intramuscular morphine and non-steroidal anti-inflammatory drugs. Central nervous system adverse effects were common.
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Dihydrocodeine is a synthetic opioid analgesic developed in the early 1900s. Its structure and pharmacokinetics are similar to that of codeine and it is used for the treatment of postoperative pain or as an antitussive. It is becoming increasingly important to assess the relative efficacy and harm caused by different treatments. Relative efficacy can be determined when an analgesic is compared with control under similar clinical circumstances. ⋯ A single 30 mg dose of dihydrocodeine is not sufficient to provide adequate pain relief in postoperative pain. Statistical superiority of ibuprofen 400 mg over dihydrocodeine (30 mg or 60 mg) was shown.
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Cochrane Db Syst Rev · Jan 2000
ReviewAntihypertensive therapy for preventing cardiovascular complications in people with diabetes mellitus.
To assess the effect of intervention, both pharmacological and non-parmacological, to reduce blood pressure in people with diabetes mellitus on all cause mortality, specific causes of death, including cardiovascular disease, stroke, ischaemic heart disease and renal disease, morbidity associated with macro- and microvascular complications of diabetes mellitus and also side effects of the interventions and their influence on quality of life and well being. ⋯ Primary intervention trials indicated a treatment benefit for CVD, but not for total mortality in people with diabetes. For both short- and long-term secondary prevention, the present meta-analysis indicated a benefit for total mortality in diabetic subjects. However lack of information on CVD outcomes probably reduced the power of the meta-analysis to detect any corresponding benefit for this end-point. This, along with the fact that all published data of randomised control trials of anti-hypertensive therapy in diabetes for all cause mortailty and CVD outcomes are taken from the hypertension trials not specific to diabetes, underlines the need for further high quality trials examining the effects of blood pressure lowering interventions in people with diabetes.
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Cochrane Db Syst Rev · Jan 2000
ReviewPerioperative local anaesthesia for reducing pain following tonsillectomy.
Pain relief after tonsillectomy is an important part of post-operative management. Sometimes local anaesthetics are administed to the tonsillar region, but their effectiveness in relieving pain has not been formally assessed. ⋯ There is no evidence that the use of perioperative local anaesthetic in patients undergoing tonsillectomy improves post-operative pain control. The trials identified were of small size and several involved the perioperative co-administration of intravenous opiates which may have masked any beneficial effect of the local anaesthetic. Further randomised controlled trials are necessary.