Cochrane Db Syst Rev
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Carbamazepine and valproate are drugs of first choice for epilepsy. Despite the lack of hard evidence from individual randomized controlled trials, there is strong clinical belief that valproate is the drug of choice for generalized epilepsies and carbamazepine for partial epilepsies. ⋯ We have found some evidence to support the policy of using carbamazepine as the first treatment of choice in partial epilepsies, but no evidence to support the choice of valproate in generalized epilepsies, but confidence intervals are too wide to confirm equivalence. Misclassification of patients may have confounded our results, and has important implications for the design and conduct of future trials.
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Cochrane Db Syst Rev · Jan 2000
ReviewMultidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults.
Multidisciplinary biopsychosocial rehabilitation programs are widely applied for chronic low back pain patients. The biopsychosocial approach for low back pain could also be considered to prevent chronicity by carrying out the rehabilitation if the acute pain is prolonged. Nevertheless multidisciplinary treatment programmes are often laborious and long processes and require good collaboration between the patient, the rehabilitation team and the work place. By workplace visits and close relationship with occupational health care one might expect results in terms of patients working ability. ⋯ We conclude that there is moderate evidence of positive effectiveness of multidisciplinary rehabilitation for subacute low back pain and workplace visit increases the effectiveness. But because this evidence is based on the trials that had some methodological shortcomings and several expensive multidisciplinary rehabilitation programmes are commonly used for common subacute low back problems, there is an obvious need for high quality trials in this field.
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Cochrane Db Syst Rev · Jan 2000
ReviewEpidural versus non-epidural analgesia for pain relief in labour.
Epidural analgesia is effective in reducing labour pain, but the possible adverse effects are not clear. ⋯ Epidural analgesia appears to be very effective in reducing pain during labour, although there appear to be some potentially adverse effects. Further research is needed to investigate adverse effects and to evaluate the different techniques used in epidural analgesia.
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Since the introduction of the Swedish back school in 1980, the content of back schools has changed and appears to vary widely today. Back schools are frequently used in the treatment of low back pain patients. ⋯ Back schools may be effective for patients with recurrent and chronic low back pain in occupational settings, but little is known about the cost-effectiveness of back schools.
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Cochrane Db Syst Rev · Jan 2000
ReviewFetal electrocardiogram plus heart rate recording for fetal monitoring during labour.
It is thought that adding fetal electrocardiography (ECG) to cardiotocography (CTG) alone may provide better information about fetal heart activity. ⋯ Analysis of the fetal electrocardiographic waveform during labour may be associated with reduced obstetric intervention without jeopardising fetal outcome.