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Effects of a gluten-reduced or gluten-free diet for the primary prevention of cardiovascular disease
CONCLUSIONS: Very low-certainty evidence suggested that it is unclear whether gluten intake is associated with all-cause mortality. Our findings also indicate that low-certainty evidence may show little or no association between gluten intake and cardiovascular mortality and non-fatal myocardial infarction. Low-certainty evidence suggested that a lower compared with a higher gluten intake may be associated with a slightly increased risk to develop type 2 diabetes - a major cardiovascular risk factor. For other cardiovascular risk factors it is unclear whether there is a difference between a gluten-free and normal diet. Giv...
Source: Cochrane Database of Systematic Reviews - February 24, 2022 Category: General Medicine Authors: Christine Schmucker Angelika Eisele-Metzger Joerg J Meerpohl Cornelius Lehane Daniela Kuellenberg de Gaudry Szimonetta Lohner Lukas Schwingshackl Source Type: research

Interventions for altering blood pressure in people with acute subarachnoid haemorrhage
CONCLUSIONS: Based on the current evidence, there is a lack of information needed to confirm or reject minimally important intervention effects on patient-important outcomes for both induced hypertension and lowered blood pressure. There is an urgent need for trials assessing the effects of altering blood pressure in people with acute subarachnoid haemorrhage. Such trials should use the SPIRIT statement for their design and the CONSORT statement for their reporting. Moreover, such trials should use methods allowing for blinded altering of blood pressure and report on patient-important outcomes such as mortality, rebleeding...
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Mathias Maagaard William K Karlsson Christian Ovesen Christian Gluud Janus C Jakobsen Source Type: research

Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery
CONCLUSIONS: There is high-quality evidence that SSRIs do not make a difference to disability or independence after stroke compared to placebo or usual care, reduced the risk of future depression, increased bone fractures and probably increased seizure risk.PMID:34780067 | DOI:10.1002/14651858.CD009286.pub4
Source: Cochrane Database of Systematic Reviews - November 15, 2021 Category: General Medicine Authors: Lynn A Legg Ann-Sofie Rudberg Xing Hua Simiao Wu Maree L Hackett Russel Tilney Linnea Lindgren Mansur A Kutlubaev Cheng-Fang Hsieh Amanda J Barugh Graeme J Hankey Erik Lundstr öm Martin Dennis Gillian E Mead Source Type: research

The effect of time spent in rehabilitation on activity limitation and impairment after stroke
CONCLUSIONS: An increase in time spent in the same type of rehabilitation after stroke results in little to no difference in meaningful activities such as activities of daily living and activities of the upper and lower limb but a small benefit in measures of motor impairment (low- to very low-certainty evidence for all findings). If the increase in time spent in rehabilitation exceeds a threshold, this may lead to improved outcomes. There is currently insufficient evidence to recommend a minimum beneficial daily amount in clinical practice. The findings of this study are limited by a lack of studies with a significant con...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Beth Clark Jill Whitall Gert Kwakkel Jan Mehrholz Sean Ewings Jane Burridge Source Type: research

Surgical and radiological interventions for treating symptomatic extracranial cervical artery dissection
CONCLUSIONS: No RCTs or CCTs compared either surgery or endovascular therapy with control. Thus, there is no available evidence to support their use for the treatment of extracranial cervical artery dissection in addition to antithrombotic therapy in people who continue to have neurological symptoms when treated with antithrombotic therapy alone.PMID:34559418 | DOI:10.1002/14651858.CD013118.pub2
Source: Cochrane Database of Systematic Reviews - September 24, 2021 Category: General Medicine Authors: Niamh Hynes Edel P Kavanagh Sherif Sultan Fionnuala Jordan Source Type: research

Interventions for reducing sedentary behaviour in people with stroke
CONCLUSIONS: Sedentary behaviour research in stroke seems important, yet the evidence is currently incomplete, and we found no evidence for beneficial effects. Current World Health Organization (WHO) guidelines recommend reducing the amount of sedentary time in people with disabilities, in general. The evidence is currently not strong enough to guide practice on how best to reduce sedentariness specifically in people with stroke. More high-quality randomised trials are needed, particularly involving participants with mobility limitations. Trials should include longer-term interventions specifically targeted at reducing tim...
Source: Cochrane Database of Systematic Reviews - June 29, 2021 Category: General Medicine Authors: David H Saunders Gillian E Mead Claire Fitzsimons Paul Kelly Frederike van Wijck Olaf Verschuren Karianne Backx Coralie English Source Type: research

Treatments for unruptured intracranial aneurysms
CONCLUSIONS: There is currently insufficient good-quality evidence to support either conservative treatment or interventional treatments (microsurgical clipping or endovascular coiling) for individuals with unruptured intracranial aneurysms. Further randomized trials are required to establish if surgery is a better option than conservative management, and if so, which surgical approach is preferred for which patients. Future studies should include consideration of important characteristics such as participant age, gender, aneurysm size, aneurysm location (anterior circulation and posterior circulation), grade of ischemia (...
Source: Cochrane Database of Systematic Reviews - May 10, 2021 Category: General Medicine Authors: Felipe Gomes de Barros Pontes Edina Mk da Silva Jose Cc Baptista-Silva Vladimir Vasconcelos Source Type: research

Prevention of depression in adults with long-term physical conditions
CONCLUSIONS: Based on evidence of very low certainty, our results may indicate the benefit of pharmacological interventions, during or directly after preventive treatment. Few trials examined short-term outcomes up to six months, nor the follow-up effects at six to 12 months, with studies suffering from great numbers of drop-outs and inconclusive results. Generalisation of results is limited as study populations and treatment regimes were very heterogeneous. Based on the results of this review, we conclude that for adults with long-term physical conditions, there is only very uncertain evidence regarding the implementation...
Source: Cochrane Database of Systematic Reviews - March 5, 2021 Category: General Medicine Authors: Hanna Kampling Harald Baumeister J ürgen Bengel Oskar Mittag Source Type: research

Patches of different types for carotid patch angioplasty.
CONCLUSIONS: The number of outcome events is too small to allow conclusions, and more trial data are required to establish whether any differences do exist. Nevertheless, there is little to no difference in effect on perioperative and long-term ipsilateral stroke between vein and any synthetic patch material. Some evidence indicates that other synthetic patches (e.g. PTFE) may be superior to Dacron grafts in terms of perioperative stroke and TIA rates, and both early and late arterial re-stenosis and occlusion. Pseudoaneurysm formation may be more common after use of a vein patch than after use of a synthetic patch. Bovin...
Source: Cochrane Database of Systematic Reviews - February 18, 2021 Category: General Medicine Authors: Orrapin S, Benyakorn T, Howard DP, Siribumrungwong B, Rerkasem K Tags: Cochrane Database Syst Rev Source Type: research

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