Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisRoutine abdominal drainage for uncomplicated open cholecystectomy.
Cholecystectomy is the removal of gallbladder and is performed mainly for symptomatic gallstones. Although laparoscopic cholecystectomy is currently preferred over open cholecystectomy for elective cholecystectomy, reports of randomised clinical trials comparing the choice of cholecystectomy (open or laparoscopic) in acute cholecystitis are still being conducted. Drainage in open cholecystectomy is a matter of considerable debate. Surgeons use drains primarily to prevent subhepatic abscess or bile peritonitis from an undrained bile leak. Critics of drain condemn drain use as it increases wound and chest infection. ⋯ Drains increase the harms to the patient without providing any additional benefit for patients undergoing open cholecystectomy and should be avoided in open cholecystectomy.
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Esophageal cancer is the seventh leading cause of cancer death worldwide. Traditional Chinese medicinal herbs are sometimes used as an adjunct to radiotherapy or chemotherapy for this type of cancer. ⋯ The included studies were of low quality. The results suggest Zhenxiang capsules or Huachansu injection may not improve short-term therapy effects or one-year survival rate when used as adjunct treatment to chemo- or radiotherapy in the treatment of esophageal cancer. The quality of life may be improved by Huachansu injection. The results suggest that more high-quality trials on Huachansu injection and other Chinese herbal medicines are needed in the future.
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Cochrane Db Syst Rev · Apr 2007
ReviewPhysical activity programs for promoting bone mineralization and growth in preterm infants.
Lack of physical stimulation may contribute to metabolic bone disease of preterm infants resulting in poor bone mineralization and growth. Physical activity programs in the presence of adequate nutrition might help to promote bone mineralization and growth. ⋯ There is weak evidence from six small randomized trials of poor methodological and reporting quality that physical activity programs might promote moderate short-term weight gain and bone mineralization in preterm infants. The clinical importance of these findings is questionable given the small effect size and low baseline risk of poor bone mineralization and growth in study participants. Data is inadequate to assess harm or long term effects. Current evidence does not justify the standard use of physical activity programs in preterm infants. Further evaluation of this intervention in well designed trials incorporating extremely low birth weight infants who are at high risk of osteopenia is required. Future trials should report on adverse events and long term outcomes including fractures, growth, bone mineralization, skeletal deformities and neurodevelopmental impairment. These trials should address the possibility that nutritional intake (calories, protein, calcium, phosphorus) might modify the effects of physical activity.
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Cochrane Db Syst Rev · Apr 2007
ReviewRehabilitation interventions for foot drop in neuromuscular disease.
"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases. ⋯ Using the primary outcome of ability to walk, only one study demonstrated a positive effect and that was an exercise programme for people with Charcot-Marie-Tooth disease. Surgery was not significantly effective in children with Duchenne Muscular Dystrophy. More evidence generated by methodologically sound trials is required.
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Cochrane Db Syst Rev · Apr 2007
Review Comparative StudyResorbable versus titanium plates for orthognathic surgery.
Recognition of some of the limitations of titanium plates and screws used for the fixation of bones has led to the development of plates manufactured from bioresorbable materials. Whilst resorbable plates appear to offer clinical advantages over metal plates in orthognathic surgery, concerns remain about the stability of fixation and the length of time required for their degradation and the possibility of foreign body reactions. ⋯ This review provides some evidence to show that there is no statistically significant difference in postoperative discomfort, level of patient satisfaction, plate exposure or infection for plate and screw fixation using either titanium or resorbable materials in orthognathic surgery.