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Source: Cochrane Database of Systematic Reviews
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Total 466 results found since Jan 2013.
Secondary prevention of recurrent venous thromboembolism after initial oral anticoagulation therapy in patients with unprovoked venous thromboembolism.
CONCLUSIONS: Evidence is currently insufficient to permit definitive conclusions concerning the effectiveness and safety of extended thromboprophylaxis in prevention of recurrent VTE after initial oral anticoagulation therapy among participants with unprovoked VTE. Additional good-quality large-scale randomised controlled trials are required before firm conclusions can be reached.
PMID: 29244199 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 15, 2017 Category: General Medicine Authors: Robertson L, Yeoh SE, Ramli A Tags: Cochrane Database Syst Rev Source Type: research
Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.
CONCLUSIONS: The available evidence demonstrates that the use of clopidogrel plus aspirin in people at high risk of cardiovascular disease and people with established cardiovascular disease without a coronary stent is associated with a reduction in the risk of myocardial infarction and ischaemic stroke, and an increased risk of major and minor bleeding compared with aspirin alone. According to GRADE criteria, the quality of evidence was moderate for all outcomes except all-cause mortality (low quality evidence) and adverse events (very low quality evidence).
PMID: 29240976 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 14, 2017 Category: General Medicine Authors: Squizzato A, Bellesini M, Takeda A, Middeldorp S, Donadini MP Tags: Cochrane Database Syst Rev Source Type: research
Yoga for stroke rehabilitation.
CONCLUSIONS: Yoga has the potential for being included as part of patient-centred stroke rehabilitation. However, this review has identified insufficient information to confirm or refute the effectiveness or safety of yoga as a stroke rehabilitation treatment. Further large-scale methodologically robust trials are required to establish the effectiveness of yoga as a stroke rehabilitation treatment.
PMID: 29220541 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 8, 2017 Category: General Medicine Authors: Lawrence M, Celestino Junior FT, Matozinho HH, Govan L, Booth J, Beecher J Tags: Cochrane Database Syst Rev Source Type: research
Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus.
CONCLUSIONS: There is no firm evidence that diet alone or physical activity alone compared to standard treatment influences the risk of T2DM and especially its associated complications in people at increased risk of developing T2DM. However, diet plus physical activity reduces or delays the incidence of T2DM in people with IGT. Data are lacking for the effect of diet plus physical activity for people with intermediate hyperglycaemia defined by other glycaemic variables. Most RCTs did not investigate patient-important outcomes.
PMID: 29205264 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 4, 2017 Category: General Medicine Authors: Hemmingsen B, Gimenez-Perez G, Mauricio D, Roqué I Figuls M, Metzendorf MI, Richter B Tags: Cochrane Database Syst Rev Source Type: research
Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack.
CONCLUSIONS: Peroxisome proliferator-activated receptor gamma agonists probably reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and may improve insulin sensitivity and the stabilisation of carotid plaques. Their effects on adverse events are uncertain. Our conclusions should be interpreted with caution considering the small number and the quality of the included studies. Further 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...
Source: Cochrane Database of Systematic Reviews - December 2, 2017 Category: General Medicine Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research
Epidural therapy for the treatment of severe pre-eclampsia in non labouring women.
CONCLUSIONS: Currently, there is insufficient evidence from randomised controlled trials to evaluate the effectiveness, safety or cost of using epidural therapy for treating severe pre-eclampsia in non-labouring women.High-quality randomised controlled trials are needed to evaluate the use of epidural agents as therapy for treatment of severe pre-eclampsia. The rationale for the use of epidural is well-founded. However there is insufficient evidence from randomised controlled trials to show that the effect of epidural translates into improved maternal and fetal outcomes. Thus, there is a need for larger, well-designed stud...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Ray A, Ray S Tags: Cochrane Database Syst Rev Source Type: research
Virtual reality for stroke rehabilitation.
CONCLUSIONS: We found evidence that the use of virtual reality and interactive video gaming was not more beneficial than conventional therapy approaches in improving upper limb function. Virtual reality may be beneficial in improving upper limb function and activities of daily living function when used as an adjunct to usual care (to increase overall therapy time). There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on gait speed, balance, participation, or quality of life. This review found that time since onset of stroke, severity of impairment, and the ty...
Source: Cochrane Database of Systematic Reviews - November 20, 2017 Category: General Medicine Authors: Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M Tags: Cochrane Database Syst Rev Source Type: research
WITHDRAWN: Pharmacological cardioversion for atrial fibrillation and flutter.
CONCLUSIONS: There is no evidence that pharmacological cardioversion of atrial fibrillation to sinus rhythm is superior to rate control. Rhythm control is associated with more adverse effects and increased hospitalisation. It does not reduce the risk of stroke. The conclusions cannot be generalised to all people with atrial fibrillation. Most of the patients included in these studies were relatively older (>60 years) with significant cardiovascular risk factors.
PMID: 29140557 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Cordina J, Mead GE Tags: Cochrane Database Syst Rev Source Type: research
WITHDRAWN: Electrical cardioversion for atrial fibrillation and flutter.
CONCLUSIONS: Electrical cardioversion (rhythm control) led to a non-significant increase in stroke risk but improved three domains of quality of life.
PMID: 29140555 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Mead GE, Elder A, Flapan AD, Cordina J Tags: Cochrane Database Syst Rev Source Type: research
Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease.
CONCLUSIONS: Our findings indicate that DOAC are as likely as warfarin to prevent all strokes and systemic embolic events without increasing risk of major bleeding events among AF patients with kidney impairment. These findings should encourage physicians to prescribe DOAC in AF patients with CKD without fear of bleeding. The major limitation is that the results of this study chiefly reflect CKD stage G3. Application of the results to CKD stage G4 patients requires additional investigation. Furthermore, we could not assess CKD stage G5 patients. Future reviews should assess participants at more advanced CKD stages. Additio...
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Kimachi M, Furukawa TA, Kimachi K, Goto Y, Fukuma S, Fukuhara S Tags: Cochrane Database Syst Rev Source Type: research
Blood pressure targets for the treatment of people with hypertension and cardiovascular disease.
CONCLUSIONS: No evidence of a difference in total mortality and serious adverse events was found between treating to a lower or to a standard blood pressure target in people with hypertension and cardiovascular disease. This suggests no net health benefit from a lower systolic blood pressure target despite the small absolute reduction in total cardiovascular serious adverse events. There was very limited evidence on adverse events, which lead to high uncertainty. At present there is insufficient evidence to justify lower blood pressure targets (≤ 135/85 mmHg) in people with hypertension and established cardiovascular dis...
Source: Cochrane Database of Systematic Reviews - October 11, 2017 Category: General Medicine Authors: Saiz LC, Gorricho J, Garjón J, Celaya MC, Muruzábal L, Malón MDM, Montoya R, López A Tags: Cochrane Database Syst Rev Source Type: research
Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome.
CONCLUSIONS: There is not enough evidence for or against NOACs or for high-intensity VKA compared to the standard VKA therapy in the secondary prevention of thrombosis in people with APS. There is some evidence of harm for high-intensity VKA regarding minor and any bleeding. The evidence was also not sufficient to show benefit or harm for VKA plus antiplatelet agent or dual antiplatelet therapy compared to a single antiplatelet drug. Future studies should be adequately powered, with proper adherence to treatment, in order to evaluate the effects of anticoagulants, antiplatelets, or both, for secondary thrombosis prevention...
Source: Cochrane Database of Systematic Reviews - October 2, 2017 Category: General Medicine Authors: Bala MM, Celinska-Lowenhoff M, Szot W, Padjas A, Kaczmarczyk M, Swierz MJ, Undas A Tags: Cochrane Database Syst Rev Source Type: research
Whole grain cereals for the primary or secondary prevention of cardiovascular disease.
CONCLUSIONS: There is insufficient evidence from RCTs of an effect of whole grain diets on cardiovascular outcomes or on major CVD risk factors such as blood lipids and blood pressure. Trials were at unclear or high risk of bias with small sample sizes and relatively short-term interventions, and the overall quality of the evidence was low. There is a need for well-designed, adequately powered RCTs with longer durations assessing cardiovascular events as well as cardiovascular risk factors.
PMID: 28836672 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Kelly SA, Hartley L, Loveman E, Colquitt JL, Jones HM, Al-Khudairy L, Clar C, Germanò R, Lunn HR, Frost G, Rees K Tags: Cochrane Database Syst Rev Source Type: research
Homocysteine-lowering interventions for preventing cardiovascular events.
CONCLUSIONS: In this third update of the Cochrane review, there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination comparing with placebo on myocardial infarction, death from any cause or adverse events. In terms of stroke, this review found a small difference in effect favouring to homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination comparing with placebo.There were uncertain effects of enalapril plus folic acid compared with enalapril on stroke; approxima...
Source: Cochrane Database of Systematic Reviews - August 17, 2017 Category: General Medicine Authors: Martí-Carvajal AJ, Solà I, Lathyris D, Dayer M Tags: Cochrane Database Syst Rev Source Type: research
Treadmill training and body weight support for walking after stroke.
CONCLUSIONS: Overall, people after stroke who receive treadmill training, with or without body weight support, are not more likely to improve their ability to walk independently compared with people after stroke not receiving treadmill training, but walking speed and walking endurance may improve slightly in the short term. Specifically, people with stroke who are able to walk (but not people who are dependent in walking at start of treatment) appear to benefit most from this type of intervention with regard to walking speed and walking endurance. This review did not find, however, that improvements in walking speed and en...
Source: Cochrane Database of Systematic Reviews - August 17, 2017 Category: General Medicine Authors: Mehrholz J, Thomas S, Elsner B Tags: Cochrane Database Syst Rev Source Type: research
