Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2004
Review Meta AnalysisPit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents.
Fissure sealants used on occlusal tooth surfaces were introduced in the 1960s for protecting pits and fissures from dental caries. Although sealants have demonstrated to be effective in preventing caries, their efficacy may be related to the background caries prevalence in the population. ⋯ Sealing with resin based sealants is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars. However, we recommend that the caries prevalence level of both individuals and the population should be taken into account. In practice, the benefit of sealing should be considered locally and specified guidelines for clinicians should be used. The methodological quality of published studies concerning pit and fissure sealants was poorer than expected.
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Cochrane Db Syst Rev · Jan 2004
ReviewGlucocorticoid corticosteroids for Duchenne muscular dystrophy.
Duchenne muscular dystrophy is the most common muscular dystrophy of childhood. This incurable disease is characterised by muscle wasting and loss of walking ability leading to complete wheelchair dependence by 13 years of age. Prolongation of walking is one of the major aims of treatment. ⋯ There is evidence from randomised controlled studies that glucocorticoid corticosteroid therapy in Duchenne muscular dystrophy improves muscle strength and function in the short-term (six months to two years). The most effective prednisolone regime appears to be 0.75 mg/kg/day. In the short term, adverse effects were significantly more common but not clinically severe. Long-term benefits and hazards of glucocorticoid treatment cannot be evaluated from the currently published randomised studies. Non-randomised studies support the conclusions of functional benefits but also indicate clinically significant adverse effects of long-term treatment. These benefits and adverse effects have implications for future research studies and clinical practice.
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Cochrane Db Syst Rev · Jan 2004
Review Meta AnalysisConcomitant hydroxyurea plus radiotherapy versus radiotherapy for carcinoma of the uterine cervix.
A number of randomised studies suggest hydroxyurea given alongside radiotherapy improves survival in patients with locally advanced cervix cancer. Following publication of five large randomised trials in 1999 and 2000 concomitant chemoradiotherapy has become standard treatment for these patients. In two of the studies hydroxyurea was given to patients in both control and experimental arms. The precise role of this orally administered cytotoxic drug is not known. ⋯ We found no evidence to support the use of hydroxyurea in addition to radiotherapy in the routine treatment of cervix cancer.
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Cochrane Db Syst Rev · Jan 2004
ReviewCerebrospinal fluid drainage for thoracic and thoracoabdominal aortic aneurysm surgery.
During aortic aneurysm surgery, cross-clamping can lead to inadequate blood supply to the spinal cord resulting in neurological deficit. Cerebrospinal fluid drainage (CSFD) may increase the perfusion pressure to the spinal cord and hence reduce the risk of ischaemic spinal cord injury. ⋯ There are limited data supporting the role of CSFD in thoracic and thoracoabdominal aneurysm surgery for prevention of neurological injury. Further clinical and experimental studies are indicated.
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Clonidine was originally used to lower blood pressure. It acts on the central nervous system and may reduce withdrawal symptoms in various addictive behaviours, including tobacco use. ⋯ Based on a small number of trials, in which there are potential sources of bias, clonidine is effective in promoting smoking cessation. Prominent side-effects limit the usefulness of clonidine for smoking cessation.