Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisIleostomy or colostomy for temporary decompression of colorectal anastomosis.
The use of loop ileostomy or loop transverse colostomy represents an important issue in colorectal surgery. Despite a slight preference for a loop ileostomy as a temporary stoma, the best form for temporary decompression of colorectal anastomosis still remains controversial. ⋯ The best available evidence for decompression of colorectal anastomosis, either use of loop ileostomy or loop colostomy, could not be clarified from this review. So far, the results in terms of occurrence of postoperative stoma prolapse support the choice of loop ileostomy as a technique for fecal diversion for colorectal anastomosis, but large scale RCT's is needed to verify this.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisCombined psychotherapy plus antidepressants for panic disorder with or without agoraphobia.
Panic disorder can be treated with pharmacotherapy, psychotherapy or in combination, but the relative merits of combined therapy have not been well established. ⋯ Either combined therapy or psychotherapy alone may be chosen as first line treatment for panic disorder with or without agoraphobia, depending on patient preference.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisDietary advice for illness-related malnutrition in adults.
Illness-related malnutrition has been reported in 10% to 55% of ill people in hospital and the community in areas of food sufficiency. Dietary advice encouraging the use of energy- and nutrient-rich foods rather than oral nutritional supplements has been suggested for managing illness-related malnutrition. ⋯ This review highlights the lack of evidence for the provision of dietary advice in managing illness-related malnutrition. Dietary advice plus nutritional supplements may be more effective than dietary advice alone or no advice in enhancing short-term weight gain, but whether this is sustainable, or whether survival and morbidity are improved remains uncertain. A large adequately-powered randomised controlled trial is needed comparing the efficacy of different therapies to increase dietary intake in people with illness-related malnutrition and examining the impact of this on clinical function and survival.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisBile acids for non-alcoholic fatty liver disease and/or steatohepatitis.
Non-alcoholic fatty liver disease is a condition characterised by fatty deposition in the hepatocytes of patients in patients with minimal or no alcohol intake. Some patients develop non-alcoholic steatohepatitis. Bile acids may potentially protect cellular structures and may be of benefit in patients with non-alcoholic fatty liver or steatohepatitis. ⋯ Presently, there are insufficient data to support or refute the use of ursodeoxycholic acid for patients with non-alcoholic fatty liver or steatohepatitis. It may be advisable to carry out large randomised clinical trials on this topic.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisFamily-based programmes for preventing smoking by children and adolescents.
There is evidence that children's decisions to smoke are influenced by family and friends. ⋯ Some well-executed RCTs show family interventions may prevent adolescent smoking, but RCTs which were less well executed had mostly neutral or negative results. There is thus a need for well-designed and executed RCTs in this area.