Cochrane Db Syst Rev
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Malaria is the most common precipitating cause of crises in sickle cell disease in malaria-endemic countries. Health professionals often recommend life-long malaria chemoprophylaxis for people with sickle cell disease living in these areas. It is therefore important we have good evidence of benefit. ⋯ It is beneficial to give routine malaria chemoprophylaxis in sickle cell disease in areas where malaria is endemic.
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Massage and touch have been suggested as a non-pharmacological alternative or supplement to other treatments offered in order to reduce or manage a range of conditions associated with dementia such as anxiety, agitated behaviour and depression. It has also been suggested that massage and touch may counteract cognitive decline. ⋯ Massage and touch may serve as alternatives or complements to other therapies for the management of behavioural, emotional and perhaps other conditions associated with dementia. More research is needed, however, to provide definitive evidence about the benefits of these interventions.
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Cochrane Db Syst Rev · Oct 2006
Review Meta AnalysisPit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents.
The majority of the detected increment in dental caries is confined to pit and fissure surfaces of first molars. Application of pit and fissure sealants and topical fluorides are widely used procedures in the prevention of decay, and their effectiveness in caries prevention has been proved by systematic reviews. ⋯ There was some evidence of the superiority of pit and fissure sealants over fluoride varnish application in the prevention of occlusal decays. However, it remained unclear to what extent there is difference between the effectiveness of pit and fissure sealants and fluoride varnishes. Therefore, more high quality research is needed. No recommendations for the clinical practice could be given and the benefit of pit and fissure sealants and fluoride varnishes should be considered locally and individually.
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Diabetes has long been recognised as a strong, independent risk factor for cardiovascular disease, a problem which accounts for approximately 70% of all mortality in people with diabetes. Prospective studies show that compared to their non-diabetic counterparts, the relative risk of cardiovascular mortality for men with diabetes is two to three and for women with diabetes is three to four. The two biggest trials in type 2 diabetes, the United Kingdom Prospective Diabetes Study (UKPDS) and the University Group Diabetes Program (UGDP) study did not reveal a reduction of cardiovascular endpoints through improved metabolic control. Theoretical benefits of the newer peroxisome proliferator activated receptor gamma (PPAR-gamma) activators like pioglitazone on endothelial function and cardiovascular risk factors might result in fewer macrovascular disease events in people with type 2 diabetes mellitus. ⋯ Until new evidence becomes available, the benefit-risk ratio of pioglitazone remains unclear. Different therapeutic indications for pioglitazone of the two big U.S. and European drug agencies should be clarified to reduce uncertainties amongst patients and physicians.
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A malaria vaccine is needed because of the heavy burden of mortality and morbidity due to this disease. This review describes the results of trials of blood (asexual)-stage vaccines. Several are under development, but only one (MSP/RESA, also known as Combination B) has been tested in randomized controlled trials. ⋯ The MSP/RESA (Combination B) vaccine shows promise as a way to reduce the severity of malaria episodes, but the effect of the vaccine is MSP2 variant-specific. Pretreatment for malaria during a vaccine trial makes the results difficult to interpret, particularly with the relatively small sample sizes of early trials. The results show that blood-stage vaccines may play a role and merit further development.