Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2011
Review Meta AnalysisNon-pharmacological management of infant and young child procedural pain.
Infant acute pain and distress is commonplace. Infancy is a period of exponential development. Unrelieved pain and distress can have implications across the lifespan. ⋯ There is evidence that different non-pharmacological interventions can be used with preterms, neonates, and older infants to significantly manage pain behaviors associated with acutely painful procedures.
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Cochrane Db Syst Rev · Jan 2011
Review Meta AnalysisSweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years.
Large numbers of studies have shown that oral sucrose or glucose, with or without non-nutritive sucking given prior to painful procedures result in a significant reduction in behavioral pain responses during or following painful procedures compared with placebo, no treatment or non-nutritive sucking alone, in newborns and infants up to 12 months of age. It is not known if these pain-reducing effects exist for older infants and children one year to 16 years of age. ⋯ Based on these four studies, two of which were subgroups of small numbers of eligible toddlers from larger studies, there is insufficient evidence of the analgesic effects of sweet tasting solutions or substances during acute painful procedures in children over one year of age. Further well-conducted RCTs are warranted in this population.
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Virtual reality and interactive video gaming have emerged as new treatment approaches in stroke rehabilitation. In particular, commercial gaming consoles are being rapidly adopted in clinical settings; however, there is currently little information about their effectiveness. ⋯ We found limited evidence that the use of virtual reality and interactive video gaming may be beneficial in improving arm function and ADL function when compared with the same dose of conventional therapy. There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on grip strength or gait speed. It is unclear at present which characteristics of virtual reality are most important and it is unknown whether effects are sustained in the longer term. Furthermore, there are currently very few studies evaluating the use of commercial gaming consoles (such as the Nintendo Wii).
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Cochrane Db Syst Rev · Jan 2011
Review Meta AnalysisParenteral anticoagulation in patients with cancer who have no therapeutic or prophylactic indication for anticoagulation.
Anticoagulation may improve survival in patients with cancer through an antitumor effect in addition to the perceived antithrombotic effect. ⋯ Heparin was associated with a significant reduction of death at 24 months but not 12 months. It was also associated with a reduction in venous thromboembolism but based on the RCTs in this review it had no significant effect on major bleeding, minor bleeding or QoL. Future research should further investigate the survival benefit of different types of anticoagulants in patients with different types and stages of cancer. The decision for a patient with cancer to start heparin therapy for survival benefit should balance the benefits and downsides and integrate the patient's values and preferences.
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Cochrane Db Syst Rev · Jan 2011
Review Meta AnalysisNon-antiepileptic drugs for trigeminal neuralgia.
Non-antiepileptic drugs have been used in the management of trigeminal neuralgia since the 1970s. ⋯ Of the four studies identified, one had low and three an unclear risk of bias. There is insufficient evidence from randomized controlled trials to show significant benefit from non-antiepileptic drugs in trigeminal neuralgia. More research is needed.