Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisTherapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease.
Despite the high incidence of muscle weakness in individuals with amyotrophic lateral sclerosis (ALS) or motor neuron disease (MND), the effects of exercise in this population are not well understood. ⋯ The only studies detected were too small to determine to what extent strengthening exercises for people with ALS are beneficial, or whether exercise is harmful. There is a complete lack of randomised or quasi-randomised clinical trials examining aerobic exercise in this population. More research is needed.
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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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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisMechanical traction for neck pain with or without radiculopathy.
Neck pain is a frequently reported complaint of the musculoskeletal system which can be disabling and costly to society. Mechanical traction is often used as an adjunct therapy in outpatient rehabilitation. ⋯ The current literature does not support or refute the efficacy or effectiveness of continuous or intermittent traction for pain reduction, improved function or global perceived effect when compared to placebo traction, tablet or heat or other conservative treatments in patients with chronic neck disorders. Large, well conducted RCTs are needed to first determine the efficacy of traction, then the effectiveness, for individuals with neck disorders with radicular symptoms.
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High grade glioma (HGG) is an aggressive form of brain tumour the treatment of which usually entails biopsy or resection where possible followed by radiotherapy. Temozolomide is a novel oral chemotherapeutic drug that penetrates into the brain and has a low incidence of adverse effects. ⋯ Temozolomide is an effective therapy in GBM for prolonging survival and delaying progression as part of primary therapy without impacting on QoL and with a low incidence of early adverse events. The frequency and severity of late adverse events is unknown. In recurrent GBM it improves time to progression but not overall survival. These findings are from three good quality but non-blinded RCTs of over 900 patients in total.
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Postpartum haemorrhage (PPH) (bleeding from the genital tract after childbirth) is a major cause of maternal mortality and disability, particularly in under-resourced areas. In these settings, poor nutrition, malaria and anaemia may aggravate the effects of PPH. In addition to the standard known strategies to prevent and treat PPH, there is a need for simple, non-expensive techniques which can be applied in low-resourced settings to prevent or treat PPH. ⋯ The present review adds support to the 2004 joint statement of the International Confederation of Midwives and the International Federation of Gynaecologists and Obstetricians on the management of the third stage of labour, that uterine massage after delivery of the placenta is advised to prevent PPH. However, due to the limitations of the one trial reviewed, trials with sufficient numbers to estimate the effects of sustained uterine massage with great precision, both with and in the absence of uterotonics, are needed.