Cochrane corner: water for wound cleansing

2012 ◽  
Vol 37 (4) ◽  
pp. 375-376 ◽  
Author(s):  
J. Henton ◽  
A. Jain

Background: Although various solutions have been recommended for cleansing wounds, normal saline is favoured as it is an isotonic solution and does not interfere with the normal healing process. Tap water is commonly used in the community for cleansing wounds because it is easily accessible, efficient and cost effective; however, there is an unresolved debate about its use. Objectives: The objective of this review was to assess the effects of water compared with other solutions for wound cleansing. Search strategy: For this update we searched the Cochrane Wounds Group Specialised Register (Searched 22 February 2010); The Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library, 2010 Issue 1); Ovid MEDLINE – 2007 to February Week 2 2010; Ovid MEDLINE – In-Process & Other Non-Indexed Citations (Searched19 February 2010); Ovid EMBASE – 2007 to 2010 Week 06; EBSCO CINAHL – 2007 to 22 February 2010. Selection criteria: Randomized and quasi-randomized controlled trials that compared the use of water with other solutions for wound cleansing were eligible for inclusion. Additional criteria were outcomes that included objective or subjective measures of wound infection or healing. Data collection and analysis: Two review authors independently carried out trial selection, data extraction and quality assessment. We settled differences in opinion by discussion. We pooled some data using a random-effects model.

2013 ◽  
Vol 38 (5) ◽  
pp. 580-581 ◽  
Author(s):  
S. Buchan ◽  
R. Amirfeyz

Background: Non-surgical treatments, including ergonomic positioning or equipment, are sometimes offered to people experiencing mild to moderate symptoms from carpal tunnel syndrome. The effectiveness and duration from ergonomic positioning or equipment interventions for treating carpal tunnel syndrome are unknown. Objectives: To assess the effects of ergonomic positioning compared with no treatment, a placebo or another non-surgical intervention in people with carpal tunnel syndrome. Search methods: We searched the Cochrane Neuromuscular Disease Group Specialized Register (14 June 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (2011, Issue 2, in The Cochrane Library), MEDLINE (1966 to June 2011), EMBASE (1980 to June 2011), CINAHL Plus (1937 to June 2011), and AMED (1985 to June 2011). We also reviewed the reference lists of randomized or quasi-randomized trials identified from the electronic search. Selection criteria: Randomized or quasi-randomized controlled trials comparing ergonomic positioning or equipment with no treatment, placebo or another non-surgical intervention in people with carpal tunnel syndrome. Data collection and analysis: Two review authors independently selected trials for inclusion, extracted data and assessed risk of bias of included studies. They calculated risk ratios and mean differences with 95% confidence intervals for the primary and secondary outcomes. Results of clinically and statistically homogeneous trials were pooled, where possible, to provide estimates of the effect of ergonomic positioning or equipment.


2019 ◽  
Vol 37 (4) ◽  
pp. 294-299 ◽  
Author(s):  
Jun Kako ◽  
Masamitsu Kobayashi ◽  
Yasufumi Oosono ◽  
Kohei Kajiwara ◽  
Mika Miyashita

Background: Dyspnea is a common distressing symptom in patients with malignant and nonmalignant diseases. Fan therapy, which uses a fan to blow air toward the patient’s face, can alleviate dyspnea; however, its efficacy remains unclear. Aim: To examine the immediate efficacy of fan therapy for alleviation of dyspnea at rest. Design: Meta-analysis. Data sources: We searched the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE EBSCO, CINAHL EBSCO, and Scopus from January 1, 1987, to August 21, 2018 (PROSPERO-CRD42018108610). In addition, we hand-searched studies and used the similar articles feature on PubMed to search for articles. Randomized controlled trials comparing the effects of fan therapy with placebo or other interventions to alleviate dyspnea at rest, in which patients were aged ≥18 years, were eligible for inclusion in the review. We excluded articles on long-term intervention involving fan therapy and complex intervention (including fan therapy). The risk of bias assessment was conducted using the Cochrane tool, and the meta-analysis was performed using RevMan version 5.3. Results: We identified a total of 218 studies; 2 met our criteria for inclusion in the meta-analysis. Fan therapy significantly improved dyspnea at rest in terminally ill patients with cancer compared to control groups (mean difference: −1.31, 95% confidence interval: −1.79 to −0.83, P < .001). There were no studies that met the inclusion criteria regarding fan therapy for patients with nonmalignant disease. Conclusions: This meta-analysis demonstrated that fan therapy may be an effective intervention for dyspnea at rest in patients with terminal cancer.


2020 ◽  
Vol 5 (2) ◽  
pp. 198-204
Author(s):  
Xiao Wang ◽  
Danhong Wu ◽  
Ping Zhong

Bilirubin, a product of heme metabolism, is the most potent endogenous antioxidant which increases in many oxidative stress conditions such as stroke. It has been widely known to exert neuroprotective effect on stroke through mechanisms involved in development, therefore, it can influence the occurrence and prognosis of ischaemic stroke (IS). In this review, studies were identified by a comprehensive search of Pubmed, Embase, the Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register) and Web of Science to examine the correlation between serum bilirubin levels and risks of developing IS as well as IS outcomes. Additional studies were identified by reviewing references and contacting authors.


2020 ◽  
Vol 161 (16) ◽  
pp. 611-622
Author(s):  
Viktor L. Nagy ◽  
Zoltán Herold

Absztrakt: Bevezetés: A trimetazidin olyan metabolikus hatású anyag, amelynek hatékonysága igazolást nyert a stabil koszorúér-szindróma kezelésében. Az ajánlás szerint a trimetazidin második vonalbeli kezelésként megfontolandó az angina gyakoriságának csökkentésére és a terhelési tolerancia javítására azokban a betegekben, akiknek a tünetei nem kontrollálhatók megfelelően béta-blokkolók, kalciumcsatorna-blokkolók és tartós nitrátok adása mellett. Célkitűzés: Jelen vizsgálatunkban a különböző adagolású (3 × 20 mg, 2 × 35 mg, 1 × 80 mg) trimetazidinkészítmények hatékonyságát kívántuk tisztázni stabil angina pectorisban. Az elsődleges klinikai célváltozók a következők voltak: heti anginaszám, valamint a heti rövid hatástartamú sublingualis nitrátfogyasztás. Módszer: Mindketten adatgyűjtést végeztünk a PubMed, a Cochrane Library és a Cochrane Central Register of Controlled Trials adatbázisokban az 1967-től 2019. szeptember 30-ig terjedő időszakra vonatkozóan. A statisztikai elemzést standard metaanalízis-módszerekkel hajtottuk végre. Eredmények: Összesen 31 randomizált, kontrollált, illetve obszervációs tanulmány került bevonásra. 9856 beteg (átlagéletkor: 59,6 év, férfi: 61,6%) kezelését értékeltük. A trimetazidin a randomizált tanulmányokban a placebóval összehasonlítva csökkentette a heti anginaszámot (átlagos különbség: –1,84, 95% CI: –2,39; –1,30; p<0,0001) és a heti nitroglicerin-fogyasztást (–1,65, 95% CI: –2,17; –1,14; p<0,0001). A trimetazidin a kiinduláshoz képest a kombinációs és az obszervációs vizsgálatokban csökkentette a heti anginaszámot (átlagos különbség: –3,73, 95% CI: –4,53; –2,92; p<0,0001) és a heti nitroglicerin-fogyasztást (–3,23, 95% CI: –4,23; –2,24; p<0,0001). A három kezelési dózis között az anginaszám csökkenésében és a nitroglicerin-fogyasztásban nem lehetett különbséget kimutatni (p = 0,57, illetve p = 0,48). További eredményeink: a két primer változó vizitről vizitre csökkent; nagyobb beválasztási anginaszám a rövidebb időtartamú tanulmányokban és a kisebb adagú trimetazidint kapók között fordult elő gyakrabban, és ezek a betegek a többieknél fiatalabbak voltak. A rövidebb időtartamú tanulmányokban a kezdeti nitroglicerin-igény, illetve a -csökkenés nagyobb volt a hosszabb időtartamúakhoz képest. Következtetések: A trimetazidin kedvező klinikai hatású stabil angina pectorisban, az alkalmazott adagtól függetlenül. Új megállapításunk az, hogy a súlyosabb állapotú, fiatalabb betegek kezelésének klinikai haszna a legnagyobb. Orv Hetil. 2020; 161(16): 611–622.


2020 ◽  
Vol 31 (3) ◽  
pp. 221-235 ◽  
Author(s):  
Arti. S. Naidu ◽  
Vincent Bennani ◽  
John M. Aarts Paul Brunton ◽  
Paul Brunton

Abstract There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was done to determine their effectiveness of the predominant OTC whitening agents from 2006 until 2018 where a comparison of each agent was made with a placebo, no treatment or with other OTC whitening agents. The major categories of OTC whitening agents such as dentifrices, whitening strips and paint on gels. Dentist prescribed bleaching applied at home and in-office bleaching studies and studies that demonstrated whitening products to participants were excluded. Articles were searched for in the databases of Medline (Ovid), PubMed, the Cochrane Library and Cochrane Central Register of Controlled Trials. Twenty-four articles were included in the systematic review and the quality of studies was determined by the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) ranking criteria. Compared to other OTC, strips are reported to be effective. Two studies determined whitening strips to be effective. Whitening strips have been shown to be effective when compared with placebos and other OTC whitening agents. Dentifrices are effective in changing the shade of the tooth “by removing extrinsic stains” when compared to a placebo and non-whitening dentifrices, but they are not as effective in comparison to whitening strips. There is a lack of evidence with regards to the effectiveness of paint-on gels. While there is some evidence that OTC can alter shade in the short term, there is a need for better-designed studies.


2020 ◽  
Author(s):  
Sisse Laursen ◽  
Stine Hangaard ◽  
Flemming Udsen ◽  
Peter Vestergaard ◽  
Ole Hejlesen

BACKGROUND Telemedicine is often suggested as a promising approach to support patients with diabetes. However, the effectiveness of diabetes-related telemedicine interventions in regard to patient-related outcomes requires further evaluation. Previous systematic reviews describing the effectiveness of telemedicine in diabetes management focus on a specific type of telemedicine, a specific type of diabetes, specific comparators, or specific outcomes. Moreover, the rapid development within telemedicine emphasizes the need for a new review. OBJECTIVE The present review has a broad scope with an eye to performing an updated and exhaustive review within the field. The review aims to evaluate the effectiveness of existing telemedicine solutions versus any comparator without the use of telemedicine on diabetes-related outcomes among adult patients with diabetes. METHODS The review will consider studies that include adult subjects with a diagnosis of diabetes (type 1, 2, or gestational), studies that evaluate various types of telemedicine interventions, and randomized controlled trials comparing a telemedicine intervention to any control that does not include telemedicine. Peer-reviewed full-text papers in English, Norwegian, Danish, and Swedish will be considered. A thorough search will be performed in the PubMed, CINAHL, EMBASE, and Cochrane Library Central Register of Controlled Trials (CENTRAL) databases. Data extraction will include details about the populations, study methods, interventions, and outcomes of significance based on the review objective. RESULTS The results of the review are expected to provide an estimate of the treatment effect. The studies will be pooled via statistical meta-analysis and supplemented with narrative comparisons when necessary. CONCLUSIONS The review is important as it will inform clinicians and investigators about the effect of various telemedicine solutions within the field of diabetes. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/22062


2018 ◽  
Vol 7 (11) ◽  
pp. 434 ◽  
Author(s):  
Myeong Lee ◽  
Hye Lee ◽  
Mohamed Khalil ◽  
Hyun Lim ◽  
Hyun-Ja Lim

Aromatherapy, the therapeutic use of essential oils, is often used to reduce pain in primary dysmenorrhea. Eleven databases, including four English (PubMed, AMED, EMBASE, and the Cochrane Library) and seven Korean medical databases, were searched from inception through August 2018 without restrictions on publication language. Randomized controlled trials (RCTs) testing aromatherapy for pain reduction in primary dysmenorrhea were considered. Data extraction and risk-of-bias assessments were performed by two independent reviewers. All of the trials reported superior effects of aromatherapy for pain reduction compared to placebo (n = 1787, standard mean difference (SMD): −0.91, 95% CI: −1.17 to −0.64, p < 0.00001) with high heterogeneity (I2 = 88%). A sub-analysis for inhalational aromatherapy for the alleviation of pain also showed superior effects compared to placebo (n = 704, SMD: −1.02, 95% CI: −1.59 to −0.44, p = 0.0001, I2 = 95%). With regard to aromatherapy massage, the pooled results of 11 studies showed favorable effects of aromatherapy massage on pain reduction compared to placebo aromatherapy massage (n = 793, SMD: −0.87, 95% CI: −1.14 to −0.60, p < 0.00001, I2 = 70%). Oral aromatherapy had superior effects compared to placebo (n = 290, SMD: −0.61, 95% CI: −0.91 to −0.30, p < 0.0001, I2 = 0%). In conclusion, our systemic review provides a moderate level of evidence on the superiority of aromatherapy (inhalational, massage, or oral use) for pain reduction over placebo in primary dysmenorrhea.


2020 ◽  
pp. 102-120
Author(s):  
O. E. Garanina ◽  
I. V. Samoylenko ◽  
I. L. Shlivko ◽  
I. A. Klemenova ◽  
M. S. Neznakhina ◽  
...  

Introduction. Currently, numerous studies are published by authors of different countries to demonstrate the effectiveness of noninvasive methods in the diagnosis of melanoma. Methods. A systematic search was conducted independently in the databases PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) until April 2020 according to certain inclusion criteria. Data extraction was carried out independently, followed by generalization using descriptive tables. Due to the heterogeneity of the included studies and the impossibility of carrying out a meta-analysis in view of this, we performed a narrative description. Results. A total of 765 potential publications for inclusion were found and checked, of which 53 were included. By design, the studies were assigned to studies of simultaneous design – 40, to randomized clinical trials – 7, to meta-analysis – 6. Data in the included publications on 76802 skin neoplasms were reported, of which 9070 were melanomas. The extracted data were summarized in descriptive tables. Conclusion. With continuing technological progress, the development of noninvasive imaging technologies in the diagnosis of skin melanoma should follow the path of cost-effective, simple and accurate diagnosis.


10.2196/12651 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e12651 ◽  
Author(s):  
Ruiqi Hu ◽  
Michelle Helena van Velthoven ◽  
Edward Meinert

Background Obesity is a large contributor to preventable chronic diseases and health care costs. The efficacy of wearable devices for weight management has been researched; however, there is limited knowledge on how these devices are perceived by users. Objective This study aimed to review user perspectives on wearable technology for weight management in people who are overweight and obese. Methods We searched the online databases Pubmed, Scopus, Embase, and the Cochrane library for literature published from 2008 onward. We included all types of studies using a wearable device for delivering weight-loss interventions in adults who are overweight or obese, and qualitative data were collected about participants' perspectives on the device. We performed a quality assessment using criteria relevant to different study types. The Cochrane risk of bias tool was used for randomized controlled trials. The Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) was used for nonrandomized studies. The Oxman and Guyatt Criteria were used for systematic reviews. We used the critical appraisal checklist for qualitative studies. Data were extracted into a data extraction sheet and thematically analyzed. Results We included 19 studies: 5 randomized controlled trials, 6 nonrandomized studies, 5 qualitative studies, and 3 reviews. Mixed perceptions existed for different constructs of wearable technologies, which reflects the differences in the suitability of wearable technology interventions for different individuals in different contexts. This also indicates that interventions were not often tailored to participants' motivations. In addition, very few wearable technology interventions included a thorough qualitative analysis of the participants' view on important features of the intervention that made it successful. Conclusions This study highlights the importance of determining the type of intervention most suitable for an individual before the intervention is used. Our findings could help participants find a suitable intervention that is most effective for them. Further research needs to develop a user-centered tool for obtaining comprehensive user feedback. Trial Registration PROSPERO CRD42018096932; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=96932


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