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Immediate versus delayed treatment for recently symptomatic carotid artery stenosis.
CONCLUSIONS: There is currently no high-quality evidence available to support either very early or delayed cerebral revascularization after a recent ischemic stroke. Hence, further randomized trials to identify which patients should undergo very urgent revascularization are needed. Future studies should stratify participants by age group, sex, grade of ischemia, and degree of stenosis. Currently, there is one ongoing RCT that is examining the timing of cerebral revascularization. PMID: 27611108 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 8, 2016 Category: Journals (General) Authors: Vasconcelos V, Cassola N, da Silva EM, Baptista-Silva JC Tags: Cochrane Database Syst Rev Source Type: research

Acupuncture for stroke rehabilitation.
CONCLUSIONS: From the available evidence, acupuncture may have beneficial effects on improving dependency, global neurological deficiency, and some specific neurological impairments for people with stroke in the convalescent stage, with no obvious serious adverse events. However, most included trials were of inadequate quality and size. There is, therefore, inadequate evidence to draw any conclusions about its routine use. Rigorously designed, randomised, multi-centre, large sample trials of acupuncture for stroke are needed to further assess its effects. PMID: 27562656 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 25, 2016 Category: Journals (General) Authors: Yang A, Wu HM, Tang JL, Xu L, Yang M, Liu GJ Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke.
CONCLUSIONS: At the moment, evidence of very low to moderate quality is available on the effectiveness of tDCS (anodal/cathodal/dual) versus control (sham/any other intervention) for improving ADL performance after stroke. However, there are many ongoing randomised trials that could change the quality of evidence in the future. Future studies should particularly engage those who may benefit most from tDCS after stroke and in the effects of tDCS on upper and lower limb function, muscle strength and cognitive abilities (including spatial neglect). Dropouts and adverse events should be routinely monitored and presented as sec...
Source: Cochrane Database of Systematic Reviews - March 20, 2016 Category: Journals (General) Authors: Elsner B, Kugler J, Pohl M, Mehrholz J Tags: Cochrane Database Syst Rev Source Type: research

Puerarin for ischaemic stroke.
CONCLUSIONS: There is not enough evidence to evaluate the effect of puerarin on survival or dependency in people with ischaemic stroke. High quality and large-scale RCTs with long-term follow-up are needed to assess its efficacy. PMID: 26891451 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - February 18, 2016 Category: Journals (General) Authors: Liu B, Tan Y, Wang D, Liu M Tags: Cochrane Database Syst Rev Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in patients with stroke or transient ischaemic attack.
CONCLUSIONS: PPAR-γ agonists appear to reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and improve insulin sensitivity and the stabilisation of carotid plaques. There is evidence of limited quality that they are well tolerated. However, the conclusions should be interpreted with caution considering the small number and the quality of the included studies. In future, well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular events in p...
Source: Cochrane Database of Systematic Reviews - October 29, 2015 Category: Journals (General) Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack.
CONCLUSIONS: The combined data from recent RCTs have shown no statistically significant differences between TDC and medical therapy in the prevention of recurrent ischemic stroke. TDC closure was associated with an increased risk of atrial fibrillation but not with serious adverse events. PMID: 26346232 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 8, 2015 Category: Journals (General) Authors: Li J, Liu J, Liu M, Zhang S, Hao Z, Zhang J, Zhang C Tags: Cochrane Database Syst Rev Source Type: research

Parenteral fluid regimens for improving functional outcome in people with acute stroke.
CONCLUSIONS: We found no evidence that colloids were associated with lower odds of death or dependence in the medium term after stroke compared with crystalloids, though colloids were associated with greater odds of pulmonary oedema. We found no evidence to guide the best volume, duration, or mode of parenteral fluid delivery for people with acute stroke. PMID: 26329401 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 1, 2015 Category: Journals (General) Authors: Visvanathan A, Dennis M, Whiteley W Tags: Cochrane Database Syst Rev Source Type: research

Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke.
CONCLUSIONS: This network meta-analysis showed that the risk of myocardial infarction or ischemic stroke was only increased in women using COCs containing ≥ 50 µg of estrogen. Regarding myocardial infarction or ischemic stroke, prescribing COCs with < 50 µg of estrogen seems safe. When combined with the results of studies on the risk of venous thrombosis in COC users, it seems that the COC pill containing levonorgestrel and 30 µg of estrogen is the safest oral form of hormonal contraception. PMID: 26310586 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 27, 2015 Category: Journals (General) Authors: Roach RE, Helmerhorst FM, Lijfering WM, Stijnen T, Algra A, Dekkers OM Tags: Cochrane Database Syst Rev Source Type: research

Buflomedil for acute ischaemic stroke.
CONCLUSIONS: There is insufficient evidence on the efficacy or safety of buflomedil to support its use for the treatment of acute ischaemic stroke. Given these uncertainties, the data support the rationale for an adequately powered RCT of buflomedil in people with acute ischaemic stroke. PMID: 26193704 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 20, 2015 Category: Journals (General) Authors: Wu S, Zeng Q, Liu M, Yang J, He S, Lin S, Wu B Tags: Cochrane Database Syst Rev Source Type: research

Cerebrolysin for acute ischaemic stroke.
CONCLUSIONS: Routine administration of Cerebrolysin to people with acute ischaemic stroke cannot be supported by the available evidence from RCTs. PMID: 26083192 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - June 17, 2015 Category: Journals (General) Authors: Ziganshina LE, Abakumova T Tags: Cochrane Database Syst Rev Source Type: research

Antifibrinolytic drugs for acute traumatic injury.
CONCLUSIONS: TXA safely reduces mortality in trauma patients with bleeding without increasing the risk of adverse events.  TXA should be given as early as possible and within three hours of injury, as further analysis of the CRASH-2 trial showed that treatment later than this is unlikely to be effective and may be harmful. Although there is some promising evidence for the effect of TXA in patients with TBI, substantial uncertainty remains.Two ongoing trials being conducted in patients with isolated TBI should resolve these remaining uncertainties. PMID: 25956410 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 9, 2015 Category: Journals (General) Authors: Ker K, Roberts I, Shakur H, Coats TJ Tags: Cochrane Database Syst Rev Source Type: research

Anticoagulants for acute ischaemic stroke.
CONCLUSIONS: Since the last version of the review, no new relevant studies have been published and so there is no additional information to change the conclusions. Early anticoagulant therapy is not associated with net short- or long-term benefit in people with acute ischaemic stroke. Treatment with anticoagulants reduced recurrent stroke, deep vein thrombosis and pulmonary embolism, but increased bleeding risk. The data do not support the routine use of any of the currently available anticoagulants in acute ischaemic stroke. PMID: 25764172 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 12, 2015 Category: Journals (General) Authors: Sandercock PA, Counsell C, Kane EJ Tags: Cochrane Database Syst Rev Source Type: research

Cooling for cerebral protection during brain surgery.
CONCLUSIONS: We found no evidence that the use of induced hypothermia was associated with a significant reduction in mortality or severe neurological disability, or an increase in harm in patients undergoing neurosurgery. PMID: 25626888 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - February 3, 2015 Category: Journals (General) Authors: Galvin IM, Levy R, Boyd JG, Day AG, Wallace MC Tags: Cochrane Database Syst Rev Source Type: research

Mailuoning for acute ischaemic stroke.
CONCLUSIONS: This review did not provide sufficient evidence to support the routine use of mailuoning for the treatment of people with acute ischaemic stroke. High-quality large-scale randomised controlled trials are needed to confirm the efficacy of mailuoning. PMID: 25574904 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 9, 2015 Category: Journals (General) Authors: Yang W, Shi Z, Yang HQ, Teng J, Zhao J, Xiang G Tags: Cochrane Database Syst Rev Source Type: research

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