Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisPsychotherapy for depression among incurable cancer patients.
The most common psychiatric diagnosis among cancer patients is depression; this diagnosis is even more common among patients with advanced cancer. Psychotherapy is a patient-preferred and promising strategy for treating depression among cancer patients. Several systematic reviews have investigated the effectiveness of psychological treatment for depression among cancer patients. However, the findings are conflicting, and no review has focused on depression among patients with incurable cancer. ⋯ Evidence from RCTs of moderate quality suggest that psychotherapy is useful for treating depressive states in advanced cancer patients. However, no evidence supports the effectiveness of psychotherapy for patients with clinically diagnosed depression.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisBypass surgery for chronic lower limb ischaemia.
Surgical bypass of an occluded arterial segment is one of the mainstay treatments for patients with critical limb ischaemia (CLI). However, it was introduced without formal evaluation. ⋯ There is limited evidence for the effectiveness of bypass surgery compared with other treatments; no studies compared bypass to no treatment. Further large trials are required.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisSlow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants.
The major modifiable risk factors for necrotising enterocolitis in very low birth weight infants relate to enteral feeding regimens. Observational studies suggest that conservative feeding regimens such as delaying the introduction of enteral feeds or slowly advancing feed volumes reduce the risk of necrotising enterocolitis ⋯ The currently available data do not provide evidence that slow advancement of enteral feed volumes reduces the risk of necrotising enterocolitis in very low birth weight infants. Increasing the volume of enteral feeds at slow rather than faster rates results in several days delay in regaining birth weight and establishing full enteral feeds but the long-term clinical importance of these effects is unclear. Further randomised controlled trials are needed to determine how the rate of daily increment in enteral feed volumes affects important clinical outcomes in very low birth weight infants, and particularly in extremely low birth weight or growth restricted infants.
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Fluoroquinolones are sometimes used to treat multiple-drug-resistant and drug-sensitive tuberculosis. The effects of fluoroquinolones in tuberculosis regimens need to be assessed. ⋯ Only ciprofloxacin, ofloxacin, levofloxacin, sparfloxacin and moxifloxacin have been tested in randomized controlled trials for treating tuberculosis. We cannot recommend ciprofloxacin in treating tuberculosis. Trials of newer fluoroquinolones for treating tuberculosis are needed and are on-going. No difference has been demonstrated between sparfloxacin and ofloxacin in drug-resistant tuberculosis.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisSystemic prokinetic pharmacologic treatment for postoperative adynamic ileus following abdominal surgery in adults.
Postoperative adynamic bowel atony interferes with recovery following abdominal surgery. Prokinetic pharmacologic drugs are widely used to accelerate postoperative recovery. ⋯ Alvimopan may prove to be beneficial but proper judgement needs adherence to reporting standards. Further trials are needed on intravenous lidocaine and neostigmine. The remaining drugs can not be recommended due to lack of evidence or absence of effect.