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Source: Cochrane Database of Systematic Reviews
Condition: Stroke

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Total 462 results found since Jan 2013.

Continuation versus discontinuation of antiplatelet therapy for bleeding and ischaemic events in adults undergoing non-cardiac surgery.
CONCLUSIONS: We found low-certainty evidence that either continuation or discontinuation of antiplatelet therapy before non-cardiac surgery may make little or no difference to mortality, bleeding requiring surgical intervention, or ischaemic events. We found moderate-certainty evidence that either continuation or discontinuation of antiplatelet therapy before non-cardiac surgery probably makes little or no difference to bleeding requiring transfusion. Evidence was limited to few studies with few participants, and with few events. The three ongoing studies may alter the conclusions of the review once published and assessed....
Source: Cochrane Database of Systematic Reviews - July 18, 2018 Category: General Medicine Authors: Lewis SR, Pritchard MW, Schofield-Robinson OJ, Alderson P, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Antiplatelet and anticoagulant agents for primary prevention of thrombosis in individuals with antiphospholipid antibodies.
CONCLUSIONS: There is insufficient evidence to demonstrate benefit or harm of using anticoagulants with or without ASA versus ASA alone in people with aPL antibodies and a history of recurrent pregnancy loss and with no such history; ASA versus placebo in people with aPL antibodies; and ASA with LMWH versus placebo or IVIG, and ASA with high-dose LMWH versus ASA with low-dose LMWH or UFH, in women with aPL antibodies and a history of recurrent pregnancy loss, for the primary prevention of thrombotic events. In a mixed population of people with a history of previous pregnancy loss and without such a history treated with ant...
Source: Cochrane Database of Systematic Reviews - July 13, 2018 Category: General Medicine Authors: Bala MM, Paszek E, Lesniak W, Wloch-Kopec D, Jasinska K, Undas A Tags: Cochrane Database Syst Rev Source Type: research

Mirror therapy for improving motor function after stroke.
CONCLUSIONS: The results indicate evidence for the effectiveness of mirror therapy for improving upper extremity motor function, motor impairment, activities of daily living, and pain, at least as an adjunct to conventional rehabilitation for people after stroke. Major limitations are small sample sizes and lack of reporting of methodological details, resulting in uncertain evidence quality. PMID: 29993119 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 11, 2018 Category: General Medicine Authors: Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, Dohle C Tags: Cochrane Database Syst Rev Source Type: research

Remote ischaemic conditioning for preventing and treating ischaemic stroke.
CONCLUSIONS: We found low-quality evidence that RIC may reduce the risk of recurrent stroke in participants with intracerebral artery stenosis and reduce stroke severity in participants undergoing carotid stenting, but it may increase death or dependence in participants with acute ischaemic stroke who are undergoing intravenous thrombolysis. However, there is considerable uncertainty about these conclusions because of the small number of studies and low quality of the evidence. PMID: 29974450 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 5, 2018 Category: General Medicine Authors: Zhao W, Zhang J, Sadowsky MG, Meng R, Ding Y, Ji X Tags: Cochrane Database Syst Rev Source Type: research

Automated monitoring compared to standard care for the early detection of sepsis in critically ill patients.
CONCLUSIONS: It is unclear what effect automated systems for monitoring sepsis have on any of the outcomes included in this review. Very low-quality evidence is only available on automated alerts, which is only one component of automated monitoring systems. It is uncertain whether such systems can replace regular, careful review of the patient's condition by experienced healthcare staff. PMID: 29938790 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - June 25, 2018 Category: General Medicine Authors: Warttig S, Alderson P, Evans DJ, Lewis SR, Kourbeti IS, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Interventions for improving modifiable risk factor control in the secondary prevention of stroke.
CONCLUSIONS: We found that organisational interventions may be associated with an improvement in achieving blood pressure target but we did not find any clear evidence that these interventions improve other modifiable risk factors (lipid profile, HbA1c, medication adherence) or reduce the incidence of recurrent cardiovascular events. Interventions, including patient education alone, did not lead to improvements in modifiable risk factor control or the prevention of recurrent cardiovascular events. PMID: 29734470 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 7, 2018 Category: General Medicine Authors: Bridgwood B, Lager KE, Mistri AK, Khunti K, Wilson AD, Modi P Tags: Cochrane Database Syst Rev Source Type: research

First-line drugs for hypertension.
CONCLUSIONS: First-line low-dose thiazides reduced all morbidity and mortality outcomes in adult patients with moderate to severe primary hypertension. First-line ACE inhibitors and calcium channel blockers may be similarly effective, but the evidence was of lower quality. First-line high-dose thiazides and first-line beta-blockers were inferior to first-line low-dose thiazides. PMID: 29667175 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - April 18, 2018 Category: General Medicine Authors: Wright JM, Musini VM, Gill R Tags: Cochrane Database Syst Rev Source Type: research

Haemostatic therapies for acute spontaneous intracerebral haemorrhage.
CONCLUSIONS: Based on moderate-quality evidence from one trial, platelet transfusion seems hazardous in comparison to standard care for adults with antiplatelet-associated ICH.We were unable to draw firm conclusions about the efficacy and safety of blood clotting factors for acute spontaneous ICH with or without surgery, antifibrinolytic drugs for acute spontaneous ICH, and clotting factors versus fresh frozen plasma for acute spontaneous ICH associated with anticoagulant drug use.Further RCTs are warranted, and we await the results of the 10 ongoing RCTs with interest. PMID: 29664991 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - April 17, 2018 Category: General Medicine Authors: Al-Shahi Salman R, Law ZK, Bath PM, Steiner T, Sprigg N Tags: Cochrane Database Syst Rev Source Type: research

Acupuncture for acute stroke.
CONCLUSIONS: This updated review indicates that apparently improved outcomes with acupuncture in acute stroke are confounded by the risk of bias related to use of open controls. Adverse events related to acupuncture were reported to be minor and usually did not result in stopping treatment. Future studies are needed to confirm or refute any effects of acupuncture in acute stroke. Trials should clearly report the method of randomization, concealment of allocation, and whether blinding of participants, personnel, and outcome assessors was achieved, while paying close attention to the effects of acupuncture on long-term funct...
Source: Cochrane Database of Systematic Reviews - March 30, 2018 Category: General Medicine Authors: Xu M, Li D, Zhang S Tags: Cochrane Database Syst Rev Source Type: research

Perioperative beta-blockers for preventing surgery-related mortality and morbidity.
CONCLUSIONS: According to our findings, perioperative application of beta-blockers still plays a pivotal role in cardiac surgery, as they can substantially reduce the high burden of supraventricular and ventricular arrhythmias in the aftermath of surgery. Their influence on mortality, AMI, stroke, congestive heart failure, hypotension and bradycardia in this setting remains unclear.In non-cardiac surgery, evidence shows an association of beta-blockers with increased all-cause mortality. Data from low risk of bias trials further suggests an increase in stroke rate with the use of beta-blockers. As the quality of evidence is...
Source: Cochrane Database of Systematic Reviews - March 13, 2018 Category: General Medicine Authors: Blessberger H, Kammler J, Domanovits H, Schlager O, Wildner B, Azar D, Schillinger M, Wiesbauer F, Steinwender C Tags: Cochrane Database Syst Rev Source Type: research

Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation.
CONCLUSIONS: Treatment with factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in people with AF. The absolute effect of factor Xa inhibitors compared with warfarin treatment was, however, rather small. Factor Xa inhibitors also reduced the number of ICHs, all-cause deaths and major bleedings compared with warfarin, although the evidence for a reduction in the latter is less robust. PMID: 29509959 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 6, 2018 Category: General Medicine Authors: Bruins Slot KM, Berge E Tags: Cochrane Database Syst Rev Source Type: research

Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery.
CONCLUSIONS: Our review concludes that prophylactic α-2 adrenergic agonists generally do not prevent perioperative death or major cardiac complications. For non-cardiac surgery, there is moderate-to-high quality evidence that these agents do not prevent death, myocardial infarction or stroke. Conversely, there is moderate quality evidence that these agents have important adverse effects, namely increased risks of hypotension and bradycardia. For cardiac surgery, there is moderate quality evidence that α-2 adrenergic agonists have no effect on the risk of mortality or myocardial infarction, and that they increase the risk...
Source: Cochrane Database of Systematic Reviews - March 6, 2018 Category: General Medicine Authors: Duncan D, Sankar A, Beattie WS, Wijeysundera DN Tags: Cochrane Database Syst Rev Source Type: research

Antibiotic therapy for preventing infections in people with acute stroke.
CONCLUSIONS: Preventive antibiotics had no effect on functional outcome or mortality, but significantly reduced the risk of 'overall' infections. This reduction was driven mainly by prevention of urinary tract infection; no effect for pneumonia was found. PMID: 29355906 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 22, 2018 Category: General Medicine Authors: Vermeij JD, Westendorp WF, Dippel DW, van de Beek D, Nederkoorn PJ Tags: Cochrane Database Syst Rev Source Type: research

Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults.
CONCLUSIONS: The effects of perioperative active cerebral NIRS monitoring of brain oxygenation in adults for reducing the occurrence of short-term, mild POCD are uncertain due to the low quality of the evidence. There is uncertainty as to whether active cerebral NIRS monitoring has an important effect on postoperative stroke, delirium or death because of the low number of events and wide confidence intervals. The conclusions of this review may change when the eight ongoing studies are published and the 12 studies awaiting assessment are classified. More RCTs performed in the paediatric population and high-risk patients und...
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Yu Y, Zhang K, Zhang L, Zong H, Meng L, Han R Tags: Cochrane Database Syst Rev Source Type: research

Embolisation for pulmonary arteriovenous malformation.
CONCLUSIONS: There is no evidence from randomised controlled trials for embolisation of pulmonary arteriovenous malformations. However, randomised controlled trials are not always feasible on ethical grounds. Accumulated data from observational studies suggest that embolisation is a safe procedure which reduces morbidity and mortality. A standardised approach to reporting with long-term follow-up through registry studies can help to strengthen the evidence for embolisation in the absence of randomised controlled trials. PMID: 29298459 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 4, 2018 Category: General Medicine Authors: Hsu CC, Kwan GN, Evans-Barns H, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research