Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewCognitive rehabilitation for people with schizophrenia and related conditions.
Researchers have consistently found that people with schizophrenia score more poorly than others on a wide array of cognitive tasks and that these deficits persist even when the illness is in remission. The perceived impact of cognitive impairment on day-to-day functioning has led to the development of cognitive rehabilitation techniques intended to remedy these impairments, and thus improve the functioning of people with schizophrenia. ⋯ Data are inconclusive and provide no evidence for or against cognitive rehabilitation as a treatment for schizophrenia.
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Cochrane Db Syst Rev · Jan 2000
ReviewAdjuvant chemotherapy for localised resectable soft tissue sarcoma in adults. Sarcoma Meta-analysis Collaboration (SMAC).
Individually, randomised trilas have not shown conclusively whether adjuvant chemotherapy benefits adult patients with localised resectable soft-tissue sarcoma. ⋯ Doxorubicin-based adjuvant chemotherapy appears to significantly improve time to local and distant recurrence and overall recurrence-free survival in adults with localised resectable soft tissue sarcoma. There is some evidence of a trend towards improved overall survival.
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Cochrane Db Syst Rev · Jan 2000
ReviewPrompted voiding for the management of urinary incontinence in adults.
Prompted voiding is a behavioural therapy used mainly in North American nursing homes. It aims to improve bladder control for people with or without dementia using verbal prompts and positive reinforcement. ⋯ There was insufficient evidence to reach firm conclusions for practice. There was suggestive, although inconclusive, evidence of short-term benefit from prompted voiding and from adding the muscle relaxant, Oxybutinin to prompted voiding.
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Spasticity is a common problem in MS patients causing pain, spasms, loss of function and difficulties in nursing care. A variety of oral and parenteral medications are available. ⋯ The absolute and comparative efficacy and tolerability of anti-spasticity agents in multiple sclerosis is poorly documented and no recommendations can be made to guide prescribing. The rationale for treating features of the upper motor neurone syndrome must be better understood and sensitive, validated spasticity measures need to be developed.
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Clinical practice guidelines aim to reduce inappropriate variations in practice and to promote the delivery of evidence-based health care. ⋯ There is some evidence that guideline-driven care is effective in changing the process and outcome of care provided by professions allied to medicine. However, caution is needed in generalising findings to other professions and settings.