Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Oct 2006
ReviewProgesterone for preventing pre-eclampsia and its complications.
In the past, progesterone has been advocated for prevention of pre-eclampsia and its complications. Although progestogens are not used for this purpose in current clinical practice, it remains relevant to assess the evidence on their possible benefits and harms. ⋯ There is insufficient evidence for reliable conclusions about the effects of progesterone for preventing pre-eclampsia and its complications. Therefore, progesterone should not be used for this purpose in clinical practice at present. Unless new and plausible hypotheses emerge for the role of progesterone in development of pre-eclampsia, further trials of progesterone are unlikely to be a priority.
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Cochrane Db Syst Rev · Oct 2006
ReviewSalicylate for the treatment of Kawasaki disease in children.
Kawasaki disease is the most common cause of acquired heart disease in children in developed countries. The coronary arteries supplying the heart can be damaged in Kawasaki disease. The principal advantage of timely diagnosis is the potential to prevent this complication with early treatment. Salicylate (acetyl salicylate acid (ASA), aspirin) and intravenous immunoglobulin (IVIG) are widely used for this purpose. Salicylate is largely otherwise avoided in children because of concerns about serious side effects, particularly the risk of Reyes syndrome. ⋯ Until good quality RCTs are carried out, there is insufficient evidence to indicate whether children with Kawasaki disease should continue to receive salicylate as part of their treatment regimen.
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Cochrane Db Syst Rev · Oct 2006
ReviewWeight reduction for primary prevention of stroke in adults with overweight or obesity.
Obesity is seen as a worldwide chronic disease with high prevalence that has been associated with increased morbidity from many conditions including stroke, which is the third leading cause of death in developed countries and a leading cause of severe long-term disability. The causal association between overweight or obesity and stroke is unclear and there is no definite study clarifying the role of obesity treatment in the prevention of a first stroke (primary prevention). Given the prevalence of stroke and the enormous health and economic cost of the disease, it is important to establish the possible impact of weight reduction per se on stroke incidence. ⋯ Obesity seems to be associated with an increased risk of stroke and it has been suggested that weight loss may lead to a reduction of stroke occurrence. However, this hypothesis is not based on strong scientific evidence resulting from randomised controlled clinical trials. This systematic review identified the urgent need for well-designed, adequately-powered, multi centre randomised controlled trials assessing the effects of weight reduction in persons with overweight or obesity on stroke occurrence.
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Cochrane Db Syst Rev · Oct 2006
ReviewOperative and non-operative treatment options for dislocation of the hip following total hip arthroplasty.
Dislocation following hip replacement is associated with significant morbidity and functional cost. The cause is usually multifactorial. A variety of treatment options are available which can broadly be classified into operative and non-operative. ⋯ The authors invite researchers to perform RCTs comparing different treatment options for recurrent dislocation of the hip. The heterogeneity of the population and variety of underlying causes would favour a multi-centre study to achieve an adequate sample size.
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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.