Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2007
ReviewIncentives and disincentives to participation by clinicians in randomised controlled trials.
Patients and clinicians need reliable, up-to-date information from randomised controlled trials (RCTs) on the costs and benefits of treatments. Recruitment difficulties arise when clinicians do not invite patients to participate in trials. ⋯ The impact of factors varied across studies. Researchers need to be aware that aspects of the design and conduct of trials can affect clinicians' willingness to invite patients to participate. Further research is needed.
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Hyperthyroidism is a disease in which excessive amounts of thyroid hormones circulate in the blood. Patients, among other things suffer from tachycardia, warm moist skin and raised body temperature. The treatment of hyperthyroidism includes symptom relief and therapy with antithyroid medications, radioiodine and thyroidectomy. Medicinal herbs are used alone or in combination with antithyroid agents to treat hyperthyroidism in China and some other countries. ⋯ The results suggest that traditional Chinese herbal medicines added to other routine treatment have a therapeutic potential for people with hyperthyroidism. However, due to methodological limitations, we could not identify a well-designed trial to provide strong evidence for Chinese traditional herbal medicine in the treatment of hyperthyroidism. Thus, we currently cannot recommend any single preparation or formulation for clinical use.
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Cochrane Db Syst Rev · Apr 2007
ReviewFluid replacement therapy for acute episodes of pain in people with sickle cell disease.
Treating vaso-occlusive painful crises in people with sickle cell disease is complex and requires multiple interventions. Extra fluids are routinely given as adjunct treatment, regardless of the individual's state of hydration with the aim of slowing or stopping the sickling process and thereby alleviating pain. ⋯ Treating vaso-occlusive crises is complex and requires multiple interventions. Extra fluids, generally oral or intravenous, are routinely administered during acute painful episodes to people with sickle cell disease regardless of the individual's state of hydration. Reports of their use during these acute painful episodes do not state the efficacy of any single route, type or quantity of fluid compared to another. However, there are no randomized controlled trials that have assessed the safety and efficacy of different routes, types or quantities of fluid. This systematic review identifies the need for a multicentre randomized controlled trial assessing the efficacy and possible adverse effects of different routes, types and quantities of fluid administered to people with sickle cell disease during acute painful episodes.
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Vascular dementia (VD) is a syndrome or diagnosis that has different causes and clinical manifestations relating to several different vascular mechanisms and changes in the brain. Some traditional Chinese herbal medicines were developed for treating VD. DH: Yizhi capsule is one such herbal concoction which is reported to improve clinical symptoms significantly. The efficacy and adverse effects of Yizhi capsule need to be reviewed systematically and assessed critically to inform clinical practice and guide the continued search for new treatment regimens. ⋯ There is no evidence from randomised controlled trials to support or proscribe against the use of 'Yizhi capsule' as a treatment for vascular dementia.
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Cochrane Db Syst Rev · Apr 2007
ReviewRehabilitation interventions for foot drop in neuromuscular disease.
"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases. ⋯ Using the primary outcome of ability to walk, only one study demonstrated a positive effect and that was an exercise programme for people with Charcot-Marie-Tooth disease. Surgery was not significantly effective in children with Duchenne Muscular Dystrophy. More evidence generated by methodologically sound trials is required.