Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2003
ReviewHeparin for pregnant women with acquired or inherited thrombophilias.
Thrombophilias, which are associated with a predisposition to thrombotic events, have been implicated in adverse obstetrical outcomes such as intrauterine growth restriction, stillbirth, severe early onset pre-eclampsia, and placental abruption. Heparin administration in pregnancy may reduce the risk of these events. ⋯ There are no completed trials to determine the effects of heparin on pregnancy outcomes for women with a thrombophilia.
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It is generally accepted that taxanes are among the most active chemotherapy agents in the management of metastatic breast cancer. ⋯ When all trials are considered, taxane-containing regimens appear to improve overall survival, time to progression and overall response in women with metastatic breast cancer. The degree of heterogeneity encountered indicates that taxane-containing regimens are more effective than some, but not all non-taxane-containing regimens.
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Cochrane Db Syst Rev · Jan 2003
ReviewRegular self-examination or clinical examination for early detection of breast cancer.
Breast self-examination and clinical breast examination have been promoted for many years as general screening methods to diagnose breast cancer at an earlier stage in order to decrease morbidity and or mortality. The possible benefits and harms remain unclear. ⋯ Data from two large trials do not suggest a beneficial effect of screening by breast self-examination whereas there is evidence for harms. There were no randomised trials of clinical breast examination. At present, breast self-examination cannot be recommended.
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Olanzapine, an atypical antipsychotic, is used in the treatment of mania both as monotherapy and combined with other medicines. ⋯ Olanzapine is an effective treatment for mania and may be more efficacious than divalproex, though leads to more weight gain. Clinicians should consider both the relative efficacy and the different incidence of specific adverse effects of available drugs.
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The patient with diabetes has many different learning needs relating to diet, monitoring, and treatments. In many health care systems specialist nurses provide much of these needs, usually aiming to empower patients to self-manage their diabetes. The present review aims to assess the effects of the involvement of specialist nurse care on outcomes for people with diabetes, compared to usual care in hospital clinics or primary care with no input from specialist nurses. ⋯ The presence of a diabetes specialist nurse / nurse case manager may improve patients' diabetic control over short time periods, but from currently available trials the effects over longer periods of time are not evident. There were no significant differences overall in hypoglycaemic episodes, hyperglycaemic incidents, or hospital admissions. Quality of life was not shown to be affected by input from a diabetes specialist nurse/nurse case manager.