Cochrane Db Syst Rev
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Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor prescribed for the relief of chronic pain in osteoarthritis and rheumatoid arthritis. The drug is believed to be associated with fewer adverse effects than conventional non-steroidal anti-inflammatory drugs (NSAIDs). However, the effectiveness of celecoxib in the treatment of acute pain has not yet been assessed by systematic review. ⋯ Single dose oral celecoxib is an effective means of postoperative pain relief, similar in efficacy to aspirin 600/650 mg, and paracetamol 1000 mg. The two trials included used celecoxib 200 mg, a dose 50% less than is recommended for acute pain. More trials are needed to estimate efficacy for recommended dose of 400 mg, and to reinforce current findings for 200 mg, and provide data for pooled quantitative estimates of adverse effects.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisReduced dietary salt for prevention of cardiovascular disease.
Restricting sodium intake in elevated blood pressure over short periods of time reduces blood pressure. Long term effects (on mortality, morbidity or blood pressure) of advice to reduce salt in patients with elevated or normal blood pressure are unclear. ⋯ Intensive interventions, unsuited to primary care or population prevention programmes, provide only minimal reductions in blood pressure during long-term trials. Further evaluations to assess effects on morbidity and mortality outcomes are needed for populations as a whole and for patients with elevated blood pressure. Evidence from a large and small trial showed that a low sodium diet helps in maintenance of lower blood pressure following withdrawal of antihypertensives. If this is confirmed, with no increase in cardiovascular events, then targeting of comprehensive dietary and behavioural programmes in patients with elevated blood pressure requiring drug treatment would be justified.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisSpeech and language therapy interventions for children with primary speech and language delay or disorder.
It is thought that approximately 6% of children have speech and language difficulties of which the majority will not have any other significant developmental difficulties. Whilst most children's difficulties resolve, children whose difficulties persist into primary school may have long-term problems concerning literacy, socialisation, behaviour and school attainment. ⋯ The review shows that overall there is a positive effect of speech and language therapy interventions for children with expressive phonological and expressive vocabulary difficulties. The evidence for expressive syntax difficulties is more mixed, and there is a need for further research to investigate intervention for receptive language difficulties. There is a large degree of heterogeneity in the results, and the sources of this need to be investigated.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisCorticosteroids for hospitalised children with acute asthma.
Systemic corticosteroids are used routinely in the management of children with severe acute asthma. There is a lack of consensus regarding the agent, dose and route of corticosteroid administration. ⋯ Systemic corticosteroids produce some improvements for children admitted to hospital with acute asthma. The benefits may include earlier discharge and fewer relapses. Inhaled or nebulised corticosteroids cannot be recommended as equivalent to systemic steroids at this time. Further studies examining differing doses and routes of administration for corticosteroids will clarify the optimal therapy.
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Although levodopa is the most common drug prescribed to relieve the symptoms of Parkinson's disease it is associated with motor and psychiatric side-effects. Consequently, interest has turned to alternative drugs with improved side-effect profiles to replace or augment levodopa. Amantadine, originally used as an antiviral drug, has been shown to improve the symptoms of Parkinson's disease. ⋯ A considerable amount of evidence on the effectiveness of amantadine has accrued from non-controlled trials, often in patients with Parkinsonian conditions other than idiopathic Parkinson's disease. However, rigorous analysis of the six randomised controlled trials of amantadine reveals insufficient evidence of its efficacy and safety in the treatment of idiopathic Parkinson's disease.