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Source: Cochrane Database of Systematic Reviews

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Total 466 results found since Jan 2013.

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

Interventions in outside-school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years
CONCLUSIONS: Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. Of the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have a small increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. There was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there w...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Rosa Virgara Anna Phillips Lucy K Lewis Katherine Baldock Luke Wolfenden Ty Ferguson Mandy Richardson Anthony Okely Michael Beets Carol Maher Source Type: research

Calcium supplementation for prevention of primary hypertension
CONCLUSIONS: An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease. A 2 mmHg lower systolic blood pressure is predicted to produce about 10% lower stroke mortality and about 7% lower mortality from ischaemic heart disease. There is a great need for adequately-pow...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Gabriela Cormick Agust ín Ciapponi Mar ía Luisa Cafferata Mar ía Sol Cormick Jos é M Belizán Source Type: research

Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis
CONCLUSIONS: Findings from both standard and network meta-analyses of moderate- to high-certainty evidence suggest that GLP-1RA and SGLT2i are likely to reduce the risk of CVD mortality and all-cause mortality in people with established CVD; high-certainty evidence demonstrates that treatment with SGLT2i reduce the risk of hospitalisation for HF, while moderate-certainty evidence likely supports the use of GLP-1RA to reduce fatal and non-fatal stroke. Future studies conducted in the non-diabetic CVD population will reveal the mechanisms behind how these agents improve clinical outcomes irrespective of their glucose-lowerin...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Takayoshi Kanie Atsushi Mizuno Yoshimitsu Takaoka Takahiro Suzuki Daisuke Yoneoka Yuri Nishikawa Wilson Wai San Tam Jakub Morze Andrzej Rynkiewicz Yiqiao Xin Olivia Wu Rui Providencia Joey Sw Kwong Source Type: research

Anticoagulants for acute ischaemic stroke
CONCLUSIONS: Since the last version of this review, four new relevant studies have been published, and conclusions remain consistent. People who have early anticoagulant therapy after acute ischaemic stroke do not demonstrate any net short- or long-term benefit. Treatment with anticoagulants reduced recurrent stroke, deep vein thrombosis, and pulmonary embolism but increased bleeding risk. Data do not support the routine use of any of the currently available anticoagulants for acute ischaemic stroke.PMID:34676532 | DOI:10.1002/14651858.CD000024.pub5
Source: Cochrane Database of Systematic Reviews - October 22, 2021 Category: General Medicine Authors: Xia Wang Menglu Ouyang Jie Yang Lili Song Min Yang Craig S Anderson Source Type: research

Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias
CONCLUSIONS: This meta-analysis showed that the evidence is uncertain to inform the decision to either interrupt or continue anticoagulation therapy around CA procedure in adults with arrhythmia on outcomes of thromboembolic events, major and minor bleeding, all-cause mortality, asymptomatic thromboembolic events, and a composite endpoint of thromboembolic events (stroke, systemic embolism, major bleeding, and all-cause mortality). Most studies in the review adopted a minimal interruption strategy which has the advantage of reducing the risk of bleeding while maintaining a lower level of anticoagulation to prevent periproc...
Source: Cochrane Database of Systematic Reviews - October 21, 2021 Category: General Medicine Authors: Ghada A Bawazeer Hadeel A Alkofide Aya A Alsharafi Nada O Babakr Arwa M Altorkistani Tarek S Kashour Michael Miligkos Khalid M AlFaleh Lubna A Al-Ansary Source Type: research

Screening for aspiration risk associated with dysphagia in acute stroke
CONCLUSIONS: We were unable to identify a single swallow screening tool with high and precisely estimated sensitivity and specificity based on at least one trial with low risk of bias. However, we were able to offer recommendations for further high-quality studies that are needed to improve the accuracy and clinical utility of bedside screening tools.PMID:34661279 | DOI:10.1002/14651858.CD012679.pub2
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Elizabeth Boaden Jane Burnell Lucy Hives Paola Dey Andrew Clegg Mary W Lyons C Elizabeth Lightbody Margaret A Hurley Hazel Roddam Elizabeth McInnes Anne Alexandrov Caroline L Watkins Source Type: research

Calcium channel blockers versus other classes of drugs for hypertension
CONCLUSIONS: For the treatment of hypertension, there is moderate certainty evidence that diuretics reduce major cardiovascular events and congestive heart failure more than CCBs. There is low to moderate certainty evidence that CCBs probably reduce major cardiovascular events more than beta-blockers. There is low to moderate certainty evidence that CCBs reduced stroke when compared to angiotensin-converting enzyme (ACE) inhibitors and reduced myocardial infarction when compared to angiotensin receptor blockers (ARBs), but increased congestive heart failure when compared to ACE inhibitors and ARBs. Many of the differences ...
Source: Cochrane Database of Systematic Reviews - October 17, 2021 Category: General Medicine Authors: Jiaying Zhu Ning Chen Muke Zhou Jian Guo Cairong Zhu Jie Zhou Mengmeng Ma Li He Source Type: research

Local versus general anaesthesia for carotid endarterectomy
CONCLUSIONS: The incidence of stroke and death were not convincingly different between local and general anaesthesia for people undergoing carotid endarterectomy. The current evidence supports the choice of either approach. Further high-quality studies are still needed as the evidence is of limited reliability.PMID:34642940 | DOI:10.1002/14651858.CD000126.pub5
Source: Cochrane Database of Systematic Reviews - October 13, 2021 Category: General Medicine Authors: Amaraporn Rerkasem Saritphat Orrapin Dominic Pj Howard Sothida Nantakool Kittipan Rerkasem 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

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within community dwelling populations
CONCLUSIONS: Published data suggest that if using the IQCODE for community dwelling older adults, the 16 item IQCODE may be preferable to the traditional scale due to lesser test burden and no obvious difference in accuracy. Although IQCODE test accuracy is in a range that many would consider 'reasonable', in the context of community or population settings the use of the IQCODE alone would result in substantial misdiagnosis and false reassurance. Across the included studies there were issues with heterogeneity, several potential biases and suboptimal reporting quality.PMID:34278562 | DOI:10.1002/14651858.CD010079.pub3
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Terry J Quinn Patricia Fearon Anna H Noel-Storr Camilla Young Rupert McShane David J Stott Source Type: research