Cochrane Db Syst Rev
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Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently prescribed medications worldwide and are widely used for patients with low back pain. ⋯ In conclusion, the evidence from the 51 trials included in this review suggests that NSAIDs are effective for short-term symptomatic relief in patients with acute low back pain. Furthermore, there does not seem to be a specific type of NSAID which is clearly more effective than others. Sufficient evidence on chronic low back pain is still lacking.
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Surgery on the abdominal aorta, for aneurysmal and occlusive disease is a major undertaking which requires intensive support and fluid management. Blood products are often used, but the major fluid replacement is with crystalloids or colloids. There has been controversy for many years over which fluid is optimal and a number of studies have examined this subject, without any systematic review. ⋯ Further studies are required, with sufficient sample size and power, to draw any further conclusions. There are no studies examining the effects of combination fluid therapy.
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Most people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic drug, but up to 30 % develop refractory epilepsy, especially those with partial seizures. In this review we summarise the current evidence regarding oxcarbazepine when used as an add-on treatment for drug-resistant partial epilepsy. ⋯ Oxcarbazepine has efficacy as an add-on treatment in patients with drug-resistant partial epilepsy, both in adults and children. However, trials reviewed were of relatively short duration, and provide no evidence about the long term effects of oxcarbazepine. Results cannot be extrapolated to monotherapy or to patients with other epilepsy types.
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Misoprostol is a synthetic prostaglandin which has been used to induce labour. Oral use of the drug misoprostol may be convenient, but an overdose could cause uterine hyperstimulation and precipitate labour which may be life-threatening for both mother and fetus. ⋯ Oral misoprostol may be an effective method for labour induction. However, the data on safety are lacking. It is possible that clinically effective oral regimens may have an unacceptably high incidence of complications such as uterine hyperstimulation and possibly uterine rupture.
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Cochrane Db Syst Rev · Jan 2000
ReviewVenepuncture versus heel lance for blood sampling in term neonates.
Heel lance has been the conventional method of blood sampling in neonates for screening tests. Neonates undergoing this procedure experience pain. Despite various studies evaluating the role of pharmacological and non-pharmacological interventions to date, there are no effective and practical methods to alleviate pain from heel lance. ⋯ Venepuncture, when performed by a trained phlebotomist, appears to be the method of choice for blood sampling in term neonates. For each two venepunctures instead of heel lance, the need for one additional skin puncture can be avoided. In view of the promising results derived from small studies with some methodological limitations, further well designed randomized controlled trials need to be conducted. The interventions should be compared in settings where several individuals perform the venepuncture and/or the heel lance.