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Source: Cochrane Database of Systematic Reviews
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Total 466 results found since Jan 2013.
Anticoagulation versus placebo for heart failure in sinus rhythm
CONCLUSIONS: Based on the three RCTs, there is no evidence that oral anticoagulant therapy modifies mortality in people with HF in sinus rhythm. The evidence is uncertain if warfarin has any effect on all-cause death compared to placebo or no treatment, but it may increase the risk of major bleeding events. There is no evidence of a difference in the effect of rivaroxaban on all-cause death compared to placebo. It probably reduces the risk of stroke, but probably increases the risk of major bleedings. The available evidence does not support the routine use of anticoagulation in people with HF who remain in sinus rhythm.PMI...
Source: Cochrane Database of Systematic Reviews - May 18, 2021 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł Gregory Yh Lip 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
Thrombolytic therapy for pulmonary embolism
CONCLUSIONS: Low-certainty evidence suggests that thrombolytics may reduce death following acute pulmonary embolism compared with heparin (the effectiveness was mainly driven by one trial with massive PE). Thrombolytic therapy may be helpful in reducing the recurrence of pulmonary emboli but may cause more major and minor haemorrhagic events, including haemorrhagic stroke. More studies of high methodological quality are needed to assess safety and cost effectiveness of thrombolytic therapy for people with pulmonary embolism.PMID:33857326 | DOI:10.1002/14651858.CD004437.pub6
Source: Cochrane Database of Systematic Reviews - April 15, 2021 Category: General Medicine Authors: Zhiliang Zuo Jirong Yue Bi Rong Dong Taixiang Wu Guan J Liu Qiukui Hao Source Type: research
Cholinesterase inhibitors for vascular dementia and other vascular cognitive impairments: a network meta-analysis
CONCLUSIONS: We found moderate- to high-certainty evidence that donepezil 5 mg, donepezil 10 mg, and galantamine have a slight beneficial effect on cognition in people with VCI, although the size of the change is unlikely to be clinically important. Donepezil 10 mg and galantamine 16 to 24 mg are probably associated with more adverse events than placebo. The evidence for rivastigmine was less certain. The data suggest that donepezil 10 mg has the greatest effect on cognition, but at the cost of adverse effects. The effect is modest, but in the absence of any other treatments, people living with VCI may still wish to consid...
Source: Cochrane Database of Systematic Reviews - March 11, 2021 Category: General Medicine Authors: Ceri E Battle Azmil H Abdul-Rahim Susan D Shenkin Jonathan Hewitt Terry J Quinn Source Type: research
Antibiotics for secondary prevention of coronary heart disease
CONCLUSIONS: Our present review indicates that antibiotics (macrolides or quinolones) for secondary prevention of coronary heart disease seem harmful when assessing the risk of all-cause mortality, cardiovascular mortality, and stroke at maximum follow-up and all-cause mortality, cardiovascular mortality, and sudden cardiac death at 24±6 months follow-up. Current evidence does, therefore, not support the clinical use of macrolides and quinolones for the secondary prevention of coronary heart disease. Future trials on the safety of macrolides or quinolones for the secondary prevention in patients with coronary heart diseas...
Source: Cochrane Database of Systematic Reviews - March 11, 2021 Category: General Medicine Authors: Naqash J Sethi Sanam Safi Steven Kwasi Korang Asbj ørn Hróbjartsson Maria Skoog Christian Gluud Janus C Jakobsen 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
(Ultra-)long-acting insulin analogues for people with type 1 diabetes mellitus
CONCLUSIONS: Comparing insulin detemir with NPH insulin for T1DM showed lower risk of severe hypoglycaemia in favour of insulin detemir (moderate-certainty evidence). However, the 95% prediction interval indicated inconsistency in this finding. Both insulin detemir and insulin glargine compared with NPH insulin did not show benefits or harms for severe nocturnal hypoglycaemia. For all other main outcomes with overall low risk of bias and comparing insulin analogues with each other, there was no true beneficial or harmful effect for any intervention. Data on patient-important outcomes such as QoL, macrovascular and microvas...
Source: Cochrane Database of Systematic Reviews - March 4, 2021 Category: General Medicine Authors: Bianca Hemmingsen Maria-Inti Metzendorf Bernd Richter 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
Intermittent fasting for the prevention of cardiovascular disease.
CONCLUSIONS: Intermittent fasting was seen to be superior to ad libitum feeding in reducing weight. However, this was not clinically significant. There was no significant clinical difference between IF and CER in improving cardiometabolic risk factors to reduce the risk of CVD. Further research is needed to understand the safety and risk-benefit analysis of IF in specific patient groups (e.g. patients with diabetes or eating disorders) as well as the effect on longer-term outcomes such as all-cause mortality and myocardial infarction.
PMID: 33512717 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 29, 2021 Category: General Medicine Authors: Allaf M, Elghazaly H, Mohamed OG, Fareen MFK, Zaman S, Salmasi AM, Tsilidis K, Dehghan A Tags: Cochrane Database Syst Rev Source Type: research
Blood pressure targets in adults with hypertension.
CONCLUSIONS: For the general population of persons with elevated blood pressure, the benefits of trying to achieve a lower blood pressure target rather than a standard target (≤ 140/90 mm Hg) do not outweigh the harms associated with that intervention. Further research is needed to see if some groups of patients would benefit or be harmed by lower targets. The results of this review are primarily applicable to older people with moderate to high cardiovascular risk. They may not be applicable to other populations.
PMID: 33332584 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - December 17, 2020 Category: General Medicine Authors: Arguedas JA, Leiva V, Wright JM Tags: Cochrane Database Syst Rev Source Type: research
Interventions to increase patient and family involvement in escalation of care for acute life-threatening illness in community health and hospital settings.
CONCLUSIONS: Our review identified that interactional patient-facing interventions and multi-component programmes (including staff) to increase patient and family involvement in escalation of care for acute life-threatening illness may improve patient and family knowledge about danger signs and care-seeking responses, and probably have few adverse effects on patient's anxiety levels when compared to usual care. Multi-component interventions probably have little impact on mortality rates. Further high-quality trials are required using multi-component interventions and a focus on relational elements of care. Cognitive and be...
Source: Cochrane Database of Systematic Reviews - December 8, 2020 Category: General Medicine Authors: Mackintosh NJ, Davis RE, Easter A, Rayment-Jones H, Sevdalis N, Wilson S, Adams M, Sandall J Tags: Cochrane Database Syst Rev Source Type: research
Iron chelators for acute stroke.
CONCLUSIONS: We identified two eligible RCTs for assessment. We could not demonstrate any benefit for the use of iron chelators in spontaneous intracerebral haemorrhage. The added value of iron-chelating therapy in people with ischaemic stroke or subarachnoid haemorrhage remains unknown.
PMID: 33236783 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - November 24, 2020 Category: General Medicine Authors: Van der Loo LE, Aquarius R, Teernstra O, Klijn K, Menovsky T, van Dijk JMC, Bartels R, Boogaarts HD Tags: Cochrane Database Syst Rev Source Type: research
Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus.
CONCLUSIONS: Pioglitazone reduced or delayed the development of T2DM in people at increased risk of T2DM compared with placebo (low-certainty evidence) and compared with no intervention (moderate-certainty evidence). It is unclear whether the effect of pioglitazone is sustained once discontinued. Pioglitazone compared with metformin neither showed advantage nor disadvantage regarding the development of T2DM in people at increased risk (low-certainty evidence). The data and reporting of all-cause mortality, SAEs, micro- and macrovascular complications were generally sparse. None of the included studies reported on QoL or so...
Source: Cochrane Database of Systematic Reviews - November 19, 2020 Category: General Medicine Authors: Ipsen EØ, Madsen KS, Chi Y, Pedersen-Bjergaard U, Richter B, Metzendorf MI, Hemmingsen B 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: There is evidence of very low to moderate quality on the effectiveness of tDCS versus control (sham intervention or any other intervention) for improving ADL outcomes after stroke. However, the results did not persist in a sensitivity analyses including only trials with proper allocation concealment. Evidence of low to high quality suggests that there is no effect of tDCS on arm function and leg function, muscle strength, and cognitive abilities in people after stroke. Evidence of very low quality suggests that there is an effect on hemispatial neglect. There was moderate-quality evidence that adverse events...
Source: Cochrane Database of Systematic Reviews - November 11, 2020 Category: General Medicine Authors: Elsner B, Kugler J, Pohl M, Mehrholz J Tags: Cochrane Database Syst Rev Source Type: research
