Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisMedicinal and injection therapies for mechanical neck disorders.
Controversy persists regarding medicinal therapies and injections. ⋯ The major limitations are the lack of replication of the findings and sufficiently large trials. There is moderate evidence for the benefit of intravenous methylprednisolone given within eight hours of acute whiplash, from a single trial. Lidocaine injection into myofascial trigger points appears effective in two trials. There is moderate evidence that Botulinum toxin A is not superior to saline injection for chronic MND. Muscle relaxants, analgesics and NSAIDs had limited evidence and unclear benefits.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisArtesunate versus quinine for treating severe malaria.
Severe malaria kills over a million people every year. We sought evidence of superiority of artesunate compared with the standard treatment quinine. ⋯ Intravenous artesunate is the drug of choice for adults with severe malaria, particularly if acquired in Asia. This review did not identify sufficient data to make firm conclusions about the treatment of children or the effectiveness of intramuscular artesunate. There is an urgent need to compare the effects of artesunate with quinine in African children with severe malaria. The applicability of these results to Asian children and the ethics of further research are points of debate.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisSub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery.
Local anaesthesia for cataract surgery can be provided by either sub-Tenon or topical anaesthesia. Although there is some work suggesting advantages to both techniques, there has been no recent systematic attempt to compare both techniques for all relevant outcomes. ⋯ Sub-Tenon anaesthesia provides better pain relief than topical anaesthesia for cataract surgery.
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Hypochondriasis is associated with significant medical morbidity and high health resource use. Recent studies have examined the treatment of hypochondriasis using various forms of psychotherapy. ⋯ Cognitive therapy, behavioural therapy, cognitive behavioural therapy and behavioural stress management are effective in reducing symptoms of hypochondriasis. However, studies included in the review used small numbers of participants and do not allow estimation of effect size, comparison between different types of psychotherapy or whether people are "cured". Most long-term outcome data were uncontrolled. Further studies should make use of validated rating scales, assess treatment acceptability and effect on resource use, and determine the active ingredients and nonspecific factors that are important in psychotherapy for hypochondriasis.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisNocturnal mechanical ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders.
Chronic alveolar hypoventilation is a common complication of many neuromuscular and chest wall disorders. Long-term nocturnal mechanical ventilation is increasingly used to treat it. ⋯ Current evidence about the therapeutic benefit of mechanical ventilation is weak, but consistent, suggesting alleviation of the symptoms of chronic hypoventilation in the short-term. In three small studies survival was prolonged mainly in participants with motor neuron diseases. With the exception of motor neuron disease, further larger randomised trials are needed to confirm long-term beneficial effects of nocturnal mechanical ventilation on quality of life, morbidity and mortality, to assess its cost-benefit ratio in neuromuscular and chest wall diseases and to compare the different types and modes of ventilation.