Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Aug 2010
Review Meta AnalysisAlternative magnesium sulphate regimens for women with pre-eclampsia and eclampsia.
Magnesium sulphate remains the drug of choice for both prevention and treatment of women with eclampsia. Regimens for administration of this drug have evolved over the years, but have not yet been formally evaluated. ⋯ Although strong evidence supports the use of magnesium sulphate for prevention and treatment of eclampsia, trials comparing alternative treatment regimens are too small for reliable conclusions.
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Cochrane Db Syst Rev · Aug 2010
Review Meta AnalysisVaccines for preventing cholera: killed whole cell or other subunit vaccines (injected).
Injected cholera vaccines are rarely used today, although they may have some benefit. It is valuable to summarize the evidence for effectiveness of injected cholera vaccines for comparison with newer oral vaccines (subject of a separate Cochrane Review). ⋯ Injected cholera vaccines appear to be safe and relatively more effective than usually realized. Protection against cholera persists for up to two years following a single dose of vaccine, and for three years with an annual booster. However, they have been superseded by oral vaccines.
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Cochrane Db Syst Rev · Aug 2010
Review Meta AnalysisAerosolized prostacyclin for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are critical conditions that are associated with high mortality and morbidity. Aerosolized prostacyclin has been used to improve oxygenation despite the limited evidence available so far. ⋯ There is no current evidence to support or refute the routine use of aerosolized prostacyclin for patients with ALI and ARDS. There is an urgent need for more randomized clinical trials.
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Shigella dysentery is a relatively common illness and occasionally causes death, worldwide. Mild symptoms are self-limiting but in more severe cases, antibiotics are recommended for cure and preventing relapse. The antibiotics recommended are diverse, have regional differences in sensitivity, and have side effects. ⋯ Antibiotics reduce the duration of Shigella dysentery.Regularly updated local or regional antibiotic sensitivity patterns to different species and strains of Shigella are required to guide empiric therapy. More trials adhering to standard guidelines are required to evaluate the role of antibiotics in the treatment of severe forms of Shigella dysentery and in groups who are at high risk of complications.
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Cochrane Db Syst Rev · Aug 2010
Review Meta AnalysisCalcium channel blockers versus other classes of drugs for hypertension.
Calcium channel blockers (CCBs) are a relatively new antihypertensive class. The effect of first-line CCBs on the prevention of cardiovascular events, as compared with other antihypertensive drug classes, is unknown. ⋯ Diuretics are preferred first-line over CCBs to optimize reduction of cardiovascular events. The review does not distinguish between CCBs, ACE inhibitors or ARBs, but does provide evidence supporting the use of CCBs over beta-blockers. Many of the differences found in the current review are not robust and further trials might change the conclusions. More well-designed RCTs studying the mortality and morbidity of patients taking CCBs as compared with other antihypertensive drug classes are needed for patients with different stages of hypertension, different ages, and with different co-morbidities such as diabetes.