Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisManual versus powered toothbrushing for oral health.
Specific oral bacteria, generically known as "dental plaque" are the primary cause of gingivitis (gum disease) and caries. The removal of dental plaque is thought to play a key role in the maintenance of oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. ⋯ Powered toothbrushes with a rotation oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushing. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.
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Cochrane Db Syst Rev · Jan 2003
ReviewGranulocyte transfusions for neonates with confirmed or suspected sepsis and neutropaenia.
Neonatal sepsis causes significant neonatal mortality and morbidity. Neonates, especially preterm infants, have an immaturity of granulopoeisis and have a limited capacity for progenitor cell proliferation. This results in the frequent occurrence of neutropaenia in septic neonates. Neutropaenic septic neonates have a higher mortality than neonates who are septic but not neutropaenic. Transfusion of granulocytes to septic neutropaenic neonates, therefore, may help reduce mortality and morbidity. ⋯ Currently, there is inconclusive evidence from RCTs to support or refute the routine use of granulocyte transfusions in neonates with sepsis and neutropaenia to reduce mortality and morbidity. Researchers can be encouraged to conduct adequately powered multicentre trials of granulocyte transfusions to clarify their role in neonates with sepsis and neutropaenia. Other adjuncts to antibiotics aimed at improving host defence mechanisms such as colony stimulating factors, IVIG and pentoxifylline should also be tested in RCTs.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisSublingual immunotherapy for allergic rhinitis.
Allergic rhinitis is a common condition which, at its most severe, can significantly impair quality of life despite optimal treatment with antihistamines and topical nasal corticosteroids. Allergen injection immunotherapy significantly reduces symptoms and medication requirements in allergic rhinitis but its use is limited by the possibility of severe systemic reactions. There has therefore been considerable interest in alternative routes for delivery of allergen immunotherapy, particularly the sublingual route. ⋯ SLIT is a safe treatment which significantly reduces symptoms and medication requirements in allergic rhinitis. The size of this benefit compared to that of other available therapies, particularly injection immunotherapy, is not clear, having been assessed directly in very few studies. Further research is required concentrating on optimising allergen dosage and patient selection.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisA comparison of active drugs for the treatment of dysthymia.
Many drug treatments have been proposed for the treatment of dysthymia, but with so many potential comparisons it is not possible at the present time to determine which is the treatment of choice. There is a need to know whether the different classes of antidepressants have similar efficacy. In addition, the tolerability of treatments may be even more important, since dysthymia is a chronic condition characterised by less severe symptoms than major depression. ⋯ The conclusion is that the choice of drug must be made based on consideration of drug-specific side effect properties.
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Cochrane Db Syst Rev · Jan 2003
ReviewIntra-cytoplasmic sperm injection versus conventional techniques for oocyte insemination during in vitro fertilisation in patients with non-male subfertility.
In vitro fertilisation (IVF) as treatment for male factor subfertility is associated with lower fertilisation and pregnancy rates than for other indications. Since the late 1980s several assisted fertilisation techniques have emerged and have been rapidly developed to try to enhance results for couples with male factor subfertility, or to help couples with severe male factor for whom conventional IVF was not possible. The techniques of partial zona dissection (PZD) and of subzonal microinjection of spermatozoa into the perivitelline space (SUZI) are by far surpassed by the technique of intra-cytoplasmatic sperm injection (ICSI). ICSI has proven to be the therapy of choice for couples with severe male factor subfertility. ⋯ Whether ICSI should be preferred to IVF for cases of non-male factor subfertility remains an open question. Further research should report livebirth rates and adverse events.