Cochrane Db Syst Rev
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Bronchiectasis is characterised by chronic sputum production,bronchial wall dilation,recurrent infection and airflow limitation. Methylxanthines are used in the management of airflow limitation associated with asthma and COPD, where they are also purported to have anti-inflammatory properties. In theory they may be of use in bronchiectasis. ⋯ Further research is required to establish if the methylxanthines have a role in the treatment of bronchiectasis.
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Cochrane Db Syst Rev · Jan 2001
ReviewInhaled short-acting beta2-agonists versus ipratropium for acute exacerbations of chronic obstructive pulmonary disease.
Inhaled short acting beta2 adrenergic agonists and ipratropium bromide are both used in the treatment of acute exacerbations of chronic obstructive pulmonary disease. ⋯ There are few controlled trial data concerning the use of inhaled beta2-agonist agents in acute exacerbations of COPD and none that have compared these agents directly with placebo. None of the studies used the more modern beta2-agonists used most widely in this setting (salbutamol and terbutaline). Beta2-agonists and ipratropium both produce small improvements in FEV1, but beta2-agonists may worsen PaO2 for a period. We could not draw conclusions concerning possible additive effects.
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Alcohol is a major cause of liver disease in the Western world today. S-adenosyl-L-methionine (SAMe) acts as a methyl donor for all known biological methylation reactions and participates in the synthesis of glutathione, the main cellular anti-oxidant. Randomised clinical trials have addressed the question whether SAMe has any efficacy in patients with alcoholic liver diseases. ⋯ This systematic review could not demonstrate any significant effect of SAMe on mortality, liver related mortality, mortality or liver transplantation, and liver complications of patients with alcoholic liver disease. SAMe should not be used for alcoholic liver disease outside randomised clinical trials.
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Cochrane Db Syst Rev · Jan 2001
ReviewPreoxygenation for tracheal suctioning in intubated, ventilated newborn infants.
Endotracheal suctioning for mechanically ventilated infants is routine practice in neonatal intensive care. However, this practice is associated with serious complications including lobar collapse, pneumothorax, bradycardia and hypoxemia. Increasing the inspired oxygen immediately prior to suction (preoxygenation) has been proposed as an intervention to minimise the risk of complications. ⋯ No recommendations for practice can be confidently made from the results of this review. Although preoxygenation was shown to decrease hypoxemia at the time of suctioning, other clinically important short and longer-term outcomes including adverse effects were unable to be assessed. Further studies are needed to adequately assess the effects of this widely practiced procedure.
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Cochrane Db Syst Rev · Jan 2001
ReviewD-Penicillamine for preventing retinopathy of prematurity in preterm infants.
Retinopathy of prematurity remains a common problem. A low rate of this disorder was unexpectedly observed among infants treated with intravenous d-penicillamine to prevent hyperbilirubinemia. This observation led to the investigation of its use to prevent retinopathy of prematurity. ⋯ D-penicillamine is unlikely to affect survival, and may reduce the incidence of acute ROP among survivors. Studies to date justify further investigation of this drug in a broader population; careful attention to possible side effects is needed.