Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Mar 2010
Review Meta AnalysisLay health workers in primary and community health care for maternal and child health and the management of infectious diseases.
Lay health workers (LHWs) are widely used to provide care for a broad range of health issues. Little is known, however, about the effectiveness of LHW interventions. ⋯ LHWs provide promising benefits in promoting immunisation uptake and breastfeeding, improving TB treatment outcomes, and reducing child morbidity and mortality when compared to usual care. For other health issues, evidence is insufficient to draw conclusions about the effects of LHWs.
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Cochrane Db Syst Rev · Mar 2010
Review Meta AnalysisSurgical management of localised renal cell carcinoma.
Surgical excision remains the core to the management of localised renal cancer and several studies have evaluated the safety and clinical effectiveness of laparoscopic surgery and other recently introduced interventions for the localised disease. ⋯ The main source of evidence for the current practice of laparoscopic excision of renal cancer is drawn from case series, small retrospective studies and very few small randomised controlled trials. The results and conclusions of these studies must therefore be interpreted with caution.
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Cochrane Db Syst Rev · Mar 2010
Review Meta AnalysisOlanzapine versus other atypical antipsychotics for schizophrenia.
In many countries of the industrialised world second generation ("atypical") antipsychotics have become the first line drug treatment for people with schizophrenia. The question as to whether, and if so how much, the effects of the various second generation antipsychotics differ is a matter of debate. In this review we examined how the efficacy and tolerability of olanzapine differs from that of other second generation antipsychotics. ⋯ Olanzapine may be a somewhat more efficacious drug than some other second generation antipsychotic drugs. This small superiority in efficacy needs to be weighed against a larger weight gain and associated metabolic problems than most other second generation antipsychotic drugs, except clozapine. These conclusions are tentative due to the large number of people leaving the studies early which possibly limits the validity of the findings. Further large, well-designed trials are necessary to establish the relative effects of different second generation antipsychotic drugs.
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Cochrane Db Syst Rev · Mar 2010
Review Meta AnalysisAnthelmintics for people with neurocysticercosis.
Neurocysticercosis is an infection of the brain by the larval stage of the pork tapeworm. In endemic areas it is a common cause of epilepsy. Anthelmintics (albendazole or praziquantel) may be given to kill the parasites. However, there are potential adverse effects, and the parasites may eventually die without treatment. ⋯ In patients with viable lesions, evidence from trials of adults suggests albendazole may reduce the number of lesions. In trials of non-viable lesions, seizure recurrence was substantially lower with albendazole, which is counter-intuitive. It may be that steroids influence headache during treatment, but further research is needed to test this.
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Cochrane Db Syst Rev · Mar 2010
Review Meta AnalysisInterventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people.
The prevalence of obesity is increasing globally and will, if left unchecked, have major implications for both population health and costs to health services. ⋯ Most of the included trials had methodological or reporting weaknesses and were heterogeneous in terms of participants, interventions, outcomes, and settings, so we cannot draw any firm conclusions about the effectiveness of the interventions. All of the evaluated interventions would need further investigation before it was possible to recommend them as effective strategies.