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Despite numerous controlled clinical trials, the indications for parenteral nutritional support of cancer patients undergoing chemotherapy remain controversial. The results of the published trials have therefore been subjected to meta-analysis. ⋯ In summary, for the patients in trials to date, TPN was associated with net harm. Routine use of TPN in patients undergoing chemotherapy should be strongly discouraged, and trials involving specific groups of patients or modifications in TPN should be undertaken with caution.
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Advances in therapy · Mar 1990
Meta AnalysisReduction of infectious morbidity with uterine stapling device.
Due to the recent development of absorbable surgical staples, application of gynecologic stapling methods has expanded to the field of obstetrics. Several studies have been published presenting the results of utilization of a novel hysterotomy and uterine stapling device for cesarean section (Poly CS-57, U. S. ⋯ Four studies fulfilled several criteria, including use of proper controls. A total of 383 patients were included in these studies with an infection rate of 6.4% (12/187) versus 16.3% (32/196) for the stapled and non-stapled (traditional sutured) group, respectively (p less than 0.001). The individual investigations attributed the decreased infection rate to reductions in blood loss and incisional hematoma formation and decreased reactivity of copolymer absorbable staples.