More research needed issue 19 - oct 12

The Cochrane Library and other sources regularly publish new reviews, some of which highlight the Microfracture as the Primary Treatment for lack of good quality studies on which to base Osteochondral Lesions of the Talar Dome. recommendations. This is a good starting point for identifying a new area of research. The second step is Many techniques exist for the treatment of to find out what else has been published. If you OCLs of the talar dome. Good to excellent re- would like a literature search on any of these topics sults can be consistently reached in greater please contact the Library Service on ext 3831. than 80% of patients with arthroscopic de-bridement and microfracture. However, addi-tional prospective trials should be undertaken A systematic evaluation of content, struc- to determine differences in outcome between ture, and efficacy of interventions to im- techniques, size and location of the OCL, and prove patients' self-management of cancer other patient quality factors, such as cost and This analysis provides researchers and clini- cians with a detailed overview of the various structural and content components, as well as various combinations that were tested in inter- Intralesional steroid injection for benign vention studies to improve cancer pain man- vocal fold disorders: A systematic review agement. However, because of a variety of limitations, the most efficacious intervention VFSI is well-tolerated under local anesthesia remain to be determined in future studies. in the office setting. The invasiveness and morbidity of VFSI are low and the side effects are self-limited. Meta-analyses demonstrated significant improvements from both objective and subjective measurements. Further con- Systematic Review on Sleep Disorders and trolled studies with longer follow-up periods may evaluate the effectiveness of VFSI more Existing research points to the potentially harmful effects of sleep disorders on obstetric outcomes. The limited research in this arena highlights the need for further studies regard- ing the nature and strength of this relationship. Given the multiple dimensions of sleep and pregnancy, multivariate research approaches that incorporate biological and psychosocial Endoscopic treatment with argon plasma co- agulation appears effective in the short-term outcome of chronic radiation proctopathy. There is a moderate level of evidence for the use of sucralfate enemas. Large, randomized, placebo-controlled studies evaluating endo- scopic and medical therapies for chronic radia- Omega-3 Fatty Acids in the Prevention of Atrial Fibrillation Recurrences after Cardio- A Systematic Review of Antibiotic Use and In the subgroup administered omega-3 fatty Infect ion in Breast Reconstruction: What is acids at least 4 weeks prior to cardioversion and continued thereafter, the recurrence rate of AF was significantly low. More double-blind, There is no consensus on the necessary dura- randomized, placebo-controlled, multicenter tion for antibiotic prophylaxis following breast studies with high quality and longer follow-up reconstruction. We found no benefit in patients periods are needed to affirm our conclusion. e antibiotics. Standardized definitions for antibiotic regimens, unit of analysis reporting, and a new breast reconstruction surgical site infection grading system is offered to improve available clinical data to detect undiag- domized controlled trials are warranted to best determine an optimal antibiotic regimen. There is a proliferation of newly developed risk scores using similar variables, which some- times perform poorly upon external validation. Future research should explore the recalibra- tion, validation and applicability of existing scores to other settings, particularly in low/ We found no significant association of meno- middle income countries, and on the utility of pause with asthma prevalence or incidence scores to improve diabetes-related outcomes. except for women reporting use of MHT. How- ever, these findings result from a small num- ber of studies, including only 1 large cohort with incidence rates for pre- as well as post- menopause. Further studies are needed ad- Mindfulness-based stress reduction for low dressing more closely subgroup analyses and a possible modification of the association of This review found inconclusive evidence of ef- fectiveness of MBSR in improving pain inten- sity or disability in chronic low back pain pa- tients. However, there is limited evidence that MBSR can improve pain acceptance. Further Effects of physiotherapy interventions on RCTs with larger sample sizes, adequate con- balance in multiple sclerosis: A systematic trol interventions, and longer follow-ups are needed before firm conclusions can be drawn. These findings indicate small, but significant, effects of physiotherapy on balance in people with multiple sclerosis who have a mild to moderate level of disability. However, evi-dence for severely disabled people is lacking, and further research is needed. http://www.ncbi.nlm.nih.gov/pubmed/22990349 For more information about this newsletter please contact Laura Sims in the library (ext 6688 or 3831)

Source: http://www.bfwhospitals.nhs.uk/departments/library/documents/Moreresearchneededissue19-Oct12.pdf