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Source: Cochrane Database of Systematic Reviews

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Total 466 results found since Jan 2013.

Withdrawal of antihypertensive drugs in older people.
CONCLUSIONS: There is no evidence of an effect of discontinuing compared with continuing antihypertensives used for hypertension or primary prevention of cardiovascular disease in older adults on all-cause mortality and myocardial infarction. The evidence was low to very low certainty mainly due to small studies and low event rates. These limitations mean that we cannot make any firm conclusions about the effect of deprescribing antihypertensives on these outcomes. Future research should focus on populations with the greatest uncertainty of the benefit:risk ratio for use of antihypertensive medications, such as those with ...
Source: Cochrane Database of Systematic Reviews - June 9, 2020 Category: General Medicine Authors: Reeve E, Jordan V, Thompson W, Sawan M, Todd A, Gammie TM, Hopper I, Hilmer SN, Gnjidic D Tags: Cochrane Database Syst Rev Source Type: research

Metformin monotherapy for adults with type 2 diabetes mellitus.
CONCLUSIONS: There is no clear evidence whether metformin monotherapy compared with no intervention, behaviour changing interventions or other glucose-lowering drugs influences patient-important outcomes. PMID: 32501595 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - June 4, 2020 Category: General Medicine Authors: Gnesin F, Thuesen ACB, Kähler LKA, Madsbad S, Hemmingsen B Tags: Cochrane Database Syst Rev Source Type: research

Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke.
CONCLUSIONS: Moderate-certainty evidence shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity activity. Moderate-certainty evidence also shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity impairment after stroke. Low-certainty evidence suggests that ADLs may not be improved with MP in addition to other treatment versus the other treatment. Low-certainty evidence also suggests that MP versus conventional treatment may not improve upper extremity impairment. Further study is requ...
Source: Cochrane Database of Systematic Reviews - May 24, 2020 Category: General Medicine Authors: Barclay RE, Stevenson TJ, Poluha W, Semenko B, Schubert J Tags: Cochrane Database Syst Rev Source Type: research

Reduction in saturated fat intake for cardiovascular disease.
CONCLUSIONS: The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events. ...
Source: Cochrane Database of Systematic Reviews - May 18, 2020 Category: General Medicine Authors: Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS Tags: Cochrane Database Syst Rev Source Type: research

Anti-inflammatory therapy for preventing stroke and other vascular events after ischaemic stroke or transient ischaemic attack.
CONCLUSIONS: There is currently a paucity of evidence on the use of anti-inflammatory medications for prevention of major cardiovascular events following ischaemic stroke or TIA. RCTs are needed to assess whether use of anti-inflammatory medications in this setting is beneficial. PMID: 32392374 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - May 10, 2020 Category: General Medicine Authors: Coveney S, McCabe JJ, Murphy S, O'Donnell M, Kelly PJ Tags: Cochrane Database Syst Rev Source Type: research

Pharmacological, psychological and non-invasive brain stimulation interventions for preventing depression after stroke.
CONCLUSIONS: The available evidence suggests that pharmacological interventions and psychological therapy may prevent depression and improve mood after stroke. However, there is very low certainty in these conclusions because of the very low-certainty evidence. More trials are required before reliable recommendations can be made about the routine use of such treatments after stroke. PMID: 32390167 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - May 10, 2020 Category: General Medicine Authors: Allida S, Cox KL, Hsieh CF, House A, Hackett ML Tags: Cochrane Database Syst Rev Source Type: research

Screening strategies for hypertension.
CONCLUSIONS: There is an implicit assumption that early detection of hypertension through screening can reduce the burden of morbidity and mortality, but this assumption has not been tested in rigorous research studies. High-quality evidence from RCTs or programmatic evidence from NRCTs on the effectiveness and costs or harms of different screening strategies for hypertension (mass, targeted, or opportunistic) to reduce hypertension-related morbidity and mortality is lacking. PMID: 32378196 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - May 6, 2020 Category: General Medicine Authors: Schmidt BM, Durao S, Toews I, Bavuma CM, Hohlfeld A, Nury E, Meerpohl JJ, Kredo T Tags: Cochrane Database Syst Rev Source Type: research

Chelation therapy for atherosclerotic cardiovascular disease.
CONCLUSIONS: There is currently insufficient evidence to determine the effectiveness or ineffectiveness of chelation therapy in improving clinical outcomes of people with atherosclerotic cardiovascular disease. More high-quality, randomised controlled trials are needed that assess the effects of chelation therapy on longevity and quality of life among people with atherosclerotic cardiovascular disease. PMID: 32367513 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - May 4, 2020 Category: General Medicine Authors: Villarruz-Sulit MV, Forster R, Dans AL, Tan FN, Sulit DV Tags: Cochrane Database Syst Rev Source Type: research

Interventions for sexual dysfunction following stroke.
CONCLUSIONS: Use of sertraline to treat premature ejaculation needs to be tested in further RCTs. The lack of benefit with structured sexual rehabilitation and pelvic floor physiotherapy should not be interpreted as proof of ineffectiveness. Well-designed, randomised, double-blinded, placebo-controlled trials of long-term duration are needed to determine the effectiveness of various types of interventions for sexual dysfunction. It should be noted, however, that it may not be possible to double-blind trials of complex interventions. PMID: 32356377 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - April 30, 2020 Category: General Medicine Authors: Stratton H, Sansom J, Brown-Major A, Anderson P, Ng L Tags: Cochrane Database Syst Rev Source Type: research

Aspirin and other non-steroidal anti-inflammatory drugs for the prevention of dementia.
CONCLUSIONS: There is no evidence to support the use of low-dose aspirin or other NSAIDs of any class (celecoxib, rofecoxib or naproxen) for the prevention of dementia, but there was evidence of harm. Although there were limitations in the available evidence, it seems unlikely that there is any need for further trials of low-dose aspirin for dementia prevention. If future studies of NSAIDs for dementia prevention are planned, they will need to be cognisant of the safety concerns arising from the existing studies. PMID: 32352165 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - April 29, 2020 Category: General Medicine Authors: Jordan F, Quinn TJ, McGuinness B, Passmore P, Kelly JP, Tudur Smith C, Murphy K, Devane D Tags: Cochrane Database Syst Rev Source Type: research

Organised inpatient (stroke unit) care for stroke: network meta-analysis.
CONCLUSIONS: We found moderate-quality evidence that stroke patients who receive organised inpatient (stroke unit) care are more likely to be alive, independent, and living at home one year after the stroke. The apparent benefits were independent of patient age, sex, initial stroke severity, or stroke type, and were most obvious in units based in a discrete stroke ward. We observed no systematic increase in the length of inpatient stay, but these findings had considerable uncertainty. PMID: 32324916 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - April 22, 2020 Category: General Medicine Authors: Langhorne P, Ramachandra S, Stroke Unit Trialists' Collaboration Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing silent cerebral infarcts in people with sickle cell disease.
CONCLUSIONS: We identified no trials for preventing silent cerebral infarcts in adults, or in children who do not have HbSS SCD. Long-term red blood cell transfusions may reduce the incidence of silent cerebral infarcts in children with abnormal TCD velocities, but may have little or no effect on children with normal TCD velocities. In children who are at higher risk of stroke and have not had previous long-term transfusions, long-term red blood cell transfusions probably reduce the risk of stroke, and other SCD-related complications (acute chest syndrome and painful crises). In children and adolescents at high risk of str...
Source: Cochrane Database of Systematic Reviews - April 5, 2020 Category: General Medicine Authors: Estcourt LJ, Kimber C, Hopewell S, Trivella M, Doree C, Abboud MR Tags: Cochrane Database Syst Rev Source Type: research

Physical fitness training for stroke patients.
CONCLUSIONS: Few deaths overall suggest exercise is a safe intervention but means we cannot determine whether exercise reduces mortality or the chance of death or dependency. Cardiorespiratory training and, to a lesser extent mixed training, reduce disability during or after usual stroke care; this could be mediated by improved mobility and balance. There is sufficient evidence to incorporate cardiorespiratory and mixed training, involving walking, within post-stroke rehabilitation programmes to improve fitness, balance and the speed and capacity of walking. The magnitude of VO2 peak increase after cardiorespiratory traini...
Source: Cochrane Database of Systematic Reviews - March 19, 2020 Category: General Medicine Authors: Saunders DH, Sanderson M, Hayes S, Johnson L, Kramer S, Carter DD, Jarvis H, Brazzelli M, Mead GE Tags: Cochrane Database Syst Rev Source Type: research

Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.
CONCLUSIONS: This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and low-certainty evidence suggests that increasing LCn3 slightly reduces risk of coronary heart disease mortality and events, and reduces serum triglycerides (evidence mainly from supplement trials). Increasing ALA slightly reduces risk of cardiovascular events and arrhythmia. PMID: 32114706 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - February 28, 2020 Category: General Medicine Authors: Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, Summerbell CD, Worthington HV, Song F, Hooper L Tags: Cochrane Database Syst Rev Source Type: research

Carotid artery stenting versus endarterectomy for treatment of carotid artery stenosis.
CONCLUSIONS: Stenting for symptomatic carotid stenosis is associated with a higher risk of periprocedural stroke or death than endarterectomy. This extra risk is mostly attributed to an increase in minor, non-disabling strokes occurring in people older than 70 years. Beyond the periprocedural period, carotid stenting is as effective in preventing recurrent stroke as endarterectomy. However, combining procedural safety and long-term efficacy in preventing recurrent stroke still favours endarterectomy. In people with asymptomatic carotid stenosis, there may be a small increase in the risk of periprocedural stroke or death wi...
Source: Cochrane Database of Systematic Reviews - February 24, 2020 Category: General Medicine Authors: Müller MD, Lyrer P, Brown MM, Bonati LH Tags: Cochrane Database Syst Rev Source Type: research