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Thrombolysis for acute ischaemic stroke.
CONCLUSIONS: Thrombolytic therapy given up to six hours after stroke reduces the proportion of dead or dependent people. Those treated within the first three hours derive substantially more benefit than with later treatment. This overall benefit was apparent despite an increase in symptomatic intracranial haemorrhage, deaths at seven to 10 days, and deaths at final follow-up (except for trials testing rt-PA, which had no effect on death at final follow-up). Further trials are needed to identify the latest time window, whether people with mild stroke benefit from thrombolysis, to find ways of reducing symptomatic intracrani...
Source: Cochrane Database of Systematic Reviews - August 3, 2014 Category: Journals (General) Authors: Wardlaw JM, Murray V, Berge E, Del Zoppo GJ Tags: Cochrane Database Syst Rev Source Type: research

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

Transfusion thresholds for guiding red blood cell transfusion
CONCLUSIONS: Transfusion at a restrictive haemoglobin concentration decreased the proportion of people exposed to RBC transfusion by 41% across a broad range of clinical contexts. Across all trials, no evidence suggests that a restrictive transfusion strategy impacted 30-day mortality, mortality at other time points, or morbidity (i.e. cardiac events, myocardial infarction, stroke, pneumonia, thromboembolism, infection) compared with a liberal transfusion strategy. Despite including 17 more randomised trials (and 8846 participants), data remain insufficient to inform the safety of transfusion policies in important and sele...
Source: Cochrane Database of Systematic Reviews - December 21, 2021 Category: General Medicine Authors: Jeffrey L Carson Simon J Stanworth Jane A Dennis Marialena Trivella Nareg Roubinian Dean A Fergusson Darrell Triulzi Carolyn Dor ée Paul C H ébert Source Type: research

Tranexamic acid for reducing mortality in emergency and urgent surgery.
CONCLUSIONS: There is evidence that tranexamic acid reduces blood transfusion in patients undergoing emergency or urgent surgery. There is a need for a large pragmatic clinical trial to assess the effects of routine use of tranexamic acid on mortality in a heterogeneous group of urgent and emergency surgical patients. PMID: 23440847 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - March 2, 2013 Category: Journals (General) Authors: Perel P, Ker K, Morales Uribe CH, Roberts I Tags: Cochrane Database Syst Rev Source Type: research

Nitrous oxide-based techniques versus nitrous oxide-free techniques for general anaesthesia.
CONCLUSIONS: Given the evidence from this Cochrane review, the avoidance of nitrous oxide may be reasonable in participants with pre-existing poor pulmonary function or at high risk of postoperative nausea and vomiting. Since there are eight studies awaiting classification, selection bias may exist in our systematic review. PMID: 26545294 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 6, 2015 Category: Journals (General) Authors: Sun R, Jia WQ, Zhang P, Yang K, Tian JH, Ma B, Liu Y, Jia RH, Luo XF, Kuriyama A Tags: Cochrane Database Syst Rev Source Type: research

Antiplatelet agents for chronic kidney disease
CONCLUSIONS: Antiplatelet agents probably reduced myocardial infarction and increased major bleeding, but do not appear to reduce all-cause and cardiovascular death among people with CKD and those treated with dialysis. The treatment effects of antiplatelet agents compared with each other are uncertain.PMID:35224730 | DOI:10.1002/14651858.CD008834.pub4
Source: Cochrane Database of Systematic Reviews - February 28, 2022 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Valeria M Saglimbene Marinella Ruospo Mona Razavian Jonathan C Craig Meg J Jardine Angela C Webster Giovanni Fm Strippoli Source Type: research

Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis
CONCLUSIONS: The comparative effects of different ESAs on blood transfusions, death (any cause and cardiovascular), major cardiovascular events, myocardial infarction, stroke, vascular access thrombosis, kidney failure, fatigue and breathlessness were uncertain.PMID:36791280 | DOI:10.1002/14651858.CD010590.pub3
Source: Cochrane Database of Systematic Reviews - February 15, 2023 Category: General Medicine Authors: Edmund Ym Chung Suetonia C Palmer Valeria M Saglimbene Jonathan C Craig Marcello Tonelli Giovanni Fm Strippoli Source Type: research

Systemic treatments for the prevention of venous thrombo-embolic events in paediatric cancer patients with tunnelled central venous catheters.
CONCLUSIONS: We found no significant effects of systemic treatments compared with no intervention in preventing (a)symptomatic VTE in paediatric oncology patients with CVCs. However, this could be a result of the low number of included participants, which resulted in low power. In one CCT, which compared one systemic treatment with another systemic treatment, we identified a significant reduction in symptomatic VTE with the addition of LMWH to AT supplementation.All studies investigated the prevalence of major and/or minor bleeding episodes, and none found a significant difference between study groups. None of the studies ...
Source: Cochrane Database of Systematic Reviews - September 11, 2013 Category: Journals (General) Authors: Schoot RA, Kremer LC, van de Wetering MD, van Ommen CH Tags: Cochrane Database Syst Rev Source Type: research

Parenteral anticoagulation in ambulatory patients with cancer.
CONCLUSIONS: Heparin may have a small effect on mortality at 12 months and 24 months. It is associated with a reduction in venous thromboembolism and a likely increase in minor bleeding. Future research should further investigate the survival benefit of different types of anticoagulants in patients with different types and stages of cancer. The decision for a patient with cancer to start heparin therapy for survival benefit should balance the benefits and downsides, and should integrate the patient's values and preferences. PMID: 25491949 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 10, 2014 Category: Journals (General) Authors: Akl EA, Kahale LA, Ballout RA, Barba M, Yosuico VE, van Doormaal FF, Middeldorp S, Bryant A, Schünemann H Tags: Cochrane Database Syst Rev Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) post-percutaneous coronary intervention: a network meta-analysis.
CONCLUSIONS: Very low- to moderate-certainty evidence suggests no meaningful difference in efficacy outcomes between non-vitamin K antagonist oral anticoagulants (NOAC) and vitamin K antagonists following percutaneous coronary interventions (PCI) in people with non-valvular atrial fibrillation. NOACs probably reduce the risk of recurrent hospitalisation for adverse events compared with vitamin K antagonists. Low- to moderate-certainty evidence suggests that dabigatran may reduce the rates of major and non-major bleeding, and apixaban and rivaroxaban probably reduce the rates of non-major bleeding compared with vitamin K an...
Source: Cochrane Database of Systematic Reviews - December 18, 2019 Category: General Medicine Authors: Al Said S, Alabed S, Kaier K, Tan AR, Bode C, Meerpohl JJ, Duerschmied D Tags: Cochrane Database Syst Rev Source Type: research