Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
Review Meta AnalysisLow level laser therapy (classes I, II and III) for the treatment of osteoarthritis.
Osteoarthritis (OA) affects a large proportion of the population. Low Level Laser Therapy (LLLT) is a light source that generates extremely pure light, of a single wavelength. The effect is not thermal, but rather related to photochemical reactions in the cells. LLLT was introduced as an alternative non-invasive treatment for OA about 10 years ago, but its effectiveness is still controversial. ⋯ For OA, the results are conflicting in different studies and may depend on the method of application and other features of the LLLT application. Clinicians and researchers should consistently report the characteristics of the LLLT device and the application techniques used. New trials on LLLT should make use of standardized, validated outcomes. Despite some positive findings, this meta-analysis lacked data on how LLLT effectiveness is affected by four important factors: wavelength, treatment duration of LLLT, dosage and site of application over nerves instead of joints. There is clearly a need to investigate the effects of these factors on LLLT effectiveness for OA in randomized controlled clinical trials.
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Cochrane Db Syst Rev · Jan 2000
ReviewPharmacological interventions for spasticity following spinal cord injury.
Spasticity is a major health problem for patients with a spinal cord injury (SCI) that limits patients' mobility and affects independence in activities of daily living and work. Spasticity may also cause pain, loss of range of motion, contractures, sleep disorders and impair ambulation in patients with an incomplete lesion. The effectiveness of available drugs is still uncertain and they may cause adverse effects. Assessing what works in this area is complicated by the lack of valid and reliable measurement tools. The aim of this systematic review is to critically appraise and summarise existing information of the effectiveness of available treatments and to identify areas where further research is needed. ⋯ There is insufficient evidence to assist clinicians in a rational approach to antispastic treatment for SCI. Further research is urgently needed to improve the scientific basis of patient care.
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Cochrane Db Syst Rev · Jan 2000
ReviewChest radiograph in acute respiratory infections in children.
Chest radiography is widely used in acute lower respiratory infection in children, but the benefits are unknown. ⋯ There is no evidence that chest radiography improves outcome in ambulatory children with acute lower respiratory infection. The findings do not exclude a potential effect of radiography, but the potential benefit needs to be balanced against the hazards and expense of chest radiography. The findings apply to ambulatory children only.
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Poisoning with carbon monoxide (CO) remains an important cause of accidental and intentional injury worldwide. Several unblinded nonrandomized trials have suggested that the use of hyperbaric oxygen (HBO) prevents the development of neurological sequelae. This has led to the widespread use of HBO in the management of patients with carbon monoxide poisoning. ⋯ There is no evidence that unselected use of HBO in the treatment of acute CO poisoning reduces the frequency of neurological symptoms at one month. However, evidence from the available randomized controlled trials is insufficient to provide clear guidelines for practice. Further research is needed to better define the role of HBO, if any, in the treatment of carbon monoxide poisoning. This research question is ideally suited to a multicentre, randomized, double-blind controlled trial.
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Cochrane Db Syst Rev · Jan 2000
ReviewEmollient ointment for preventing infection in preterm infants.
This section is under preparation and will be included in the next issue. ⋯ In two small studies, prophylactic application of emollient ointment decreased transepidermal water loss, decreased the severity of dermatitis, and decreased the risk of suspect sepsis and proven sepsis. Further clinical studies are warranted to validate these results.