P Pu ur rp po os se e: : Postdural puncture headache (PDPH) is an iatrogenic complication of neuraxial blockade. We systematically reviewed the literature on parturients to determine the frequency, onset, and duration of PDPH. M Me et th ho od ds s: :Citations on PDPH in the obstetrical population were identified by computerized searches, citation review, and hand searches of abstracts and conference proceedings. Citations were included if they contained extractable data on frequency, onset, or duration of PDPH. Using meta-analysis, we calculated pooled estimates of the frequency of accidental dural puncture for epidural needles and pooled estimates of the frequencies of PDPH for epidural and spinal needles.R Re es su ul lt ts s: : Parturients have approximately a 1.5% [95% confidence interval (CI) 1.5% to 1.5%) risk of accidental dural puncture with epidural insertion. Of these, approximately half (52.1%; 95% CI, 51.4% to 52.8%) will result in PDPH. The risk of PDPH from spinal needles diminishes with small diameter, atraumatic needles, but is still appreciable (Whitacre 27-gauge needle 1.7%; 95% CI, 1.6% to 1.8%). PDPH occurs as early as one day and as late as seven days after dural puncture and lasts 12 hr to seven days. C Co on nc cl lu us si io on n: : PDPH is a common complication for parturients undergoing neuraxial blockade. Objectif : Les céphalées post-ponction durale (CPPD) sont une complication iatrogène du bloc neuraxial. Une revue systématique des publications sur les parturientes a permis de déterminer la fréquence, le délai d'installation et la durée des CPPD. Méthode : Les citations sur les CPPD dans la population obstétricale ont été repérées par des recherches informatisées, la revue des références et des recherches manuelles de résumés et de comptes rendus de conférences. Les références retenues devaient comporter des données sur la fréquence, le délai d'installation et la durée des
The herbal mixtures, Essiac™ and Flor‐Essence™, are sold as nutritional supplements and used by patients to treat chronic conditions, particularly cancer. Evidence of anticancer activity for the herbal teas is limited to anecdotal reports recorded for some 40 years in Canada. Individual case reports suggest that the tea improves quality of life, alleviates pain, and in some cases, impacts cancer progression among cancer patients. Experimental studies with individual herbs have shown evidence of biological activity including antioxidant, antioestrogenic, immunostimulant, antitumour, and antiocholeretic actions. However, research that demonstrates these positive effects in the experimental setting has not been translated to the clinical arena. Currently, no clinical studies of Essiac™ or Flor‐essence™ are published, but a clinical study is being planned at the British Columbia Cancer Agency by the University of Texas‐Center for Alternative Medicine (UT‐CAM) and Tzu‐Chi Institute for Complementary and Alternative Medicine. Copyright © 2000 John Wiley & Sons, Ltd.
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