Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisAtrial natriuretic peptide for preventing and treating acute kidney injury.
Acute kidney injury (AKI) is common in hospitalised patients and is associated with significant morbidity and mortality. Despite recent advances, outcomes have not substantially changed in the last four decades. Atrial natriuretic peptide (ANP) has shown promise in animal studies, however randomised controlled trials (RCTs) have shown inconsistent clinical benefits. ⋯ ANP may be associated with improved outcomes when used in low doses for preventing AKI and in managing postsurgery AKI and should be further explored in these two settings. There were no significant adverse events in the prevention studies, however in the high dose ANP treatment studies there were significant increases hypotension and arrhythmias.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisVascular occlusion for elective liver resections.
Vascular occlusion is used to reduce blood loss during liver resection. There is considerable controversy regarding whether vascular occlusion should be used or not during elective liver resections. ⋯ Intermittent vascular occlusion seems safe in liver resection. However, it does not seem to decrease morbidity. More randomised trials seem to be needed.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisBeta-blockers for congestive heart failure in children.
Beta-blockers are an essential part of standard therapy in adult congestive heart failure and are therefore also expected to be beneficial in children. However, congestive heart failure in children differs strongly from that in adults in terms of characteristics and aetiology; also, an increased drug clearance has been reported. Paediatric needs have therefore to be specifically investigated. ⋯ There are not enough data to recommend or discourage the use of beta-blockers in children with congestive heart failure. Further investigations in clearly defined populations with standardised methodology are required to establish guidelines for therapy. Pharmacokinetic investigations of beta-blockers in children are required to provide effective dosing in future trials.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisPatient education for neck pain with or without radiculopathy.
Neck disorders are common, disabling, and costly. The effectiveness of patient education strategies is unclear. ⋯ This review has not shown effectiveness for educational interventions in various disorder types and follow-up periods, including advice to activate, advice on stress coping skills, and 'neck school'. In future research, further attention to methodological quality is necessary. Studies of multimodal interventions should consider study designs, such as factorial designs, that permit discrimination of the specific educational components.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisInterventions for preventing falls in older people living in the community.
Approximately 30% of people over 65 years of age living in the community fall each year. ⋯ Exercise interventions reduce risk and rate of falls. Research is needed to confirm the contexts in which multifactorial assessment and intervention, home safety interventions, vitamin D supplementation, and other interventions are effective.