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Source: Cochrane Database of Systematic Reviews
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Total 416 results found since Jan 2013.
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
Electromechanical-assisted training for walking after stroke.
CONCLUSIONS: People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. We concluded that eight patients need to be treated to prevent one dependency in walking. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of large definitive pragmatic phase 3 trials undertaken to address specific quest...
Source: Cochrane Database of Systematic Reviews - October 22, 2020 Category: General Medicine Authors: Mehrholz J, Thomas S, Kugler J, Pohl M, Elsner B Tags: Cochrane Database Syst Rev Source Type: research
Renin inhibitors versus angiotensin converting enzyme (ACE) inhibitors for primary hypertension.
CONCLUSIONS: For the treatment of hypertension, we have low certainty that renin inhibitors (RI) and angiotensin converting enzyme (ACE) inhibitors do not differ for all-cause mortality and myocardial infarction. We have low to moderate certainty that they do not differ for adverse events. Small reductions in blood pressure with renin inhibitors compared to ACE inhibitors are of low certainty. More independent, large, long-term trials are needed to compare RIs with ACE inhibitors, particularly assessing morbidity and mortality outcomes, but also on blood pressure-lowering effect.
PMID: 33089502 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - October 22, 2020 Category: General Medicine Authors: Wang GM, Li LJ, Tang WL, Wright JM Tags: Cochrane Database Syst Rev Source Type: research
PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease.
CONCLUSIONS: The evidence for the clinical endpoint effects of evolocumab and alirocumab were graded as high. There is a strong evidence base to prescribe PCSK9 monoclonal antibodies to people who might not be eligible for other lipid-lowering drugs, or to people who cannot meet their lipid goals on more traditional therapies, which was the main patient population of the available trials. The evidence base of PCSK9 inhibitors compared with active treatment is much weaker (low very- to low-certainty evidence) and it is unclear whether evolocumab or alirocumab might be effectively used as replacement therapies. Related...
Source: Cochrane Database of Systematic Reviews - October 20, 2020 Category: General Medicine Authors: Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP Tags: Cochrane Database Syst Rev Source Type: research
Implementation interventions to promote the uptake of evidence-based practices in stroke rehabilitation.
CONCLUSIONS: We are uncertain if implementation interventions improve healthcare professional adherence to evidence-based practice in stroke rehabilitation compared with no intervention as the certainty of the evidence is very low.
PMID: 33058172 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - October 15, 2020 Category: General Medicine Authors: Cahill LS, Carey LM, Lannin NA, Turville M, Neilson CL, Lynch EA, McKinstry CE, Han JX, O'Connor D 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: The evidence identified indicates that NOACs compared with standard-dose VKAs may increase the risk of stroke and do not appear to alter the risk of other outcomes (moderate-certainty evidence). Using high-dose VKA versus standard-dose VKA did not alter the risk of any thromboembolic event or major bleeding but may increase the risk of any form of bleeding (low-certainty evidence). Standard-dose VKA combined with an AP agent compared with standard-dose VKA alone may increase the risk of any thromboembolic event and does not appear to alter the risk of major bleeding or other outcomes (low-certainty evidence). ...
Source: Cochrane Database of Systematic Reviews - October 12, 2020 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
Motor imagery for gait rehabilitation after stroke.
CONCLUSIONS: We found very low-certainty evidence regarding the short-term benefits of MI on walking speed in individuals who have had a stroke, compared to other therapies. Evidence was insufficient to estimate the effect of MI on the dependence on personal assistance and walking endurance. Compared with other therapies, the evidence indicates that MI does not improve motor function and functional mobility after stroke (very low-certainty evidence). Evidence was also insufficient to estimate the effect of MI on gait, motor function, and functional mobility after stroke compared to placebo or no intervention. Motor Imagery...
Source: Cochrane Database of Systematic Reviews - September 23, 2020 Category: General Medicine Authors: Silva S, Borges LR, Santiago L, Lucena L, Lindquist AR, Ribeiro T Tags: Cochrane Database Syst Rev Source Type: research
Alcohol intake reduction for controlling hypertension.
CONCLUSIONS: An intervention for decreasing alcohol intake consumption did not result in differences in systolic and diastolic blood pressure when compared with a control intervention, although there was a reduction in alcohol intake favouring the active intervention. No differences were found either for overall mortality, cardiovascular mortality or cardiovascular events. No data on serious adverse events or quality of life were available to assess. Adequate randomised controlled trials are needed to provide additional evidence on this specific question.
PMID: 32960976 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 20, 2020 Category: General Medicine Authors: Acin MT, Rueda JR, Saiz LC, Parent Mathias V, Alzueta N, Solà I, Garjón J, Erviti J Tags: Cochrane Database Syst Rev Source Type: research
Carotid endarterectomy for symptomatic carotid stenosis.
CONCLUSIONS: Carotid endarterectomy reduced the risk of recurrent stroke for people with significant stenosis. Endarterectomy might be of some benefit for participants with 50% to 69% symptomatic stenosis (moderate-quality evidence) and highly beneficial for those with 70% to 99% stenosis (moderate-quality evidence).
PMID: 32918282 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 11, 2020 Category: General Medicine Authors: Rerkasem A, Orrapin S, Howard DP, Rerkasem K Tags: Cochrane Database Syst Rev Source Type: research
Blood pressure targets for the treatment of people with hypertension and cardiovascular disease.
CONCLUSIONS: We found there is probably little to no difference in total mortality and cardiovascular mortality between people with hypertension and cardiovascular disease treated to a lower compared to a standard blood pressure target. There may also be little to no difference in serious adverse events or total cardiovascular events. This suggests that no net health benefit is derived from a lower systolic blood pressure target. We found very limited evidence on withdrawals due to adverse effects, which led to high uncertainty. At present, evidence is insufficient to justify lower blood pressure targets (135/85 mmHg or le...
Source: Cochrane Database of Systematic Reviews - September 8, 2020 Category: General Medicine Authors: Saiz LC, Gorricho J, Garjón J, Celaya MC, Erviti J, Leache L Tags: Cochrane Database Syst Rev Source Type: research
Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack.
CONCLUSIONS: Multiple antiplatelet agents are more effective in reducing stroke recurrence but increase the risk of haemorrhage compared to one antiplatelet agent. The benefit in reduction of stroke recurrence seems to outweigh the harm for dual antiplatelet agents initiated in the acute setting and continued for one month. There is lack of evidence regarding multiple versus multiple antiplatelet agents. Further studies are required in different populations to establish comprehensive safety profiles and long-term outcomes to establish duration of therapy.
PMID: 32813275 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - August 16, 2020 Category: General Medicine Authors: Naqvi IA, Kamal AK, Rehman H Tags: Cochrane Database Syst Rev Source Type: research
Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis.
CONCLUSIONS: This systematic review provides moderate-quality evidence showing that ET, compared with CMT, in people with recent symptomatic severe intracranial atherosclerotic stenosis probably does not prevent recurrent stroke and appears to carry an increased hazard. The impact of delayed ET intervention (more than three weeks after a qualifying event) is unclear and may warrant further study.
PMID: 32789891 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - August 10, 2020 Category: General Medicine Authors: Wang T, Luo J, Wang X, Yang K, Jadhav V, Gao P, Ma Y, Zhao N, Jiao L Tags: Cochrane Database Syst Rev Source Type: research
Cerebrolysin for acute ischaemic stroke.
CONCLUSIONS: Moderate-quality evidence indicates that Cerebrolysin probably has little or no beneficial effect on preventing all-cause death in acute ischaemic stroke, or on the total number of people with serious adverse events. Moderate-quality evidence also indicates a potential increase in non-fatal serious adverse events with Cerebrolysin use.
PMID: 32662068 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - July 13, 2020 Category: General Medicine Authors: Ziganshina LE, Abakumova T, Hoyle CH Tags: Cochrane Database Syst Rev Source Type: research
