Cochrane Db Syst Rev
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Most ischaemic strokes are caused by blood clots blocking an artery in the brain. Clot prevention with anticoagulants might improve outcome if bleeding risks were low. This is an update of a Cochrane review first published in 1995, and previously updated in 2004. ⋯ Since the last version of the review, neither of the two new relevant studies have provided additional information to change the conclusions. In patients with acute ischaemic stroke, immediate anticoagulant therapy is not associated with net short or long-term benefit. Treatment with anticoagulants reduced recurrent stroke, deep vein thrombosis and pulmonary embolism, but increased bleeding risk. The data do not support the routine use of any the currently available anticoagulants in acute ischaemic stroke.
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Cochrane Db Syst Rev · Oct 2008
Review Meta AnalysisElectromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke.
Electromechanical and robot-assisted arm training devices are used in rehabilitation and might help to improve arm function after stroke. ⋯ Patients who receive electromechanical and robot-assisted arm training after stroke are not more likely to improve their activities of daily living, but arm motor function and strength of the paretic arm may improve. However, the results must be interpreted with caution because there were variations between the trials in the duration, amount of training and type of treatment, and in the patient characteristics.
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Cochrane Db Syst Rev · Oct 2008
Review Meta AnalysisInterventions for Old World cutaneous leishmaniasis.
Cutaneous leishmaniasis is caused by a parasitic infection and is considered one of the most serious skin diseases in many developing countries. Antimonials are the most commonly prescribed treatment but other drugs have been used with varying success. ⋯ Most trials have been designed and reported poorly, resulting in a lack of evidence for potentially beneficial treatments. There is a desperate need for large well conducted studies that evaluate long-term effects of current therapies. We suggest the creation of an international platform to improve quality and standardization of future trials in order to inform clinical practice.
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Cochrane Db Syst Rev · Oct 2008
Review Meta AnalysisPit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents.
Although pit and fissure sealants are effective in preventing caries, their efficacy may be related to the caries prevalence in the population. ⋯ Sealing is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars. The effectiveness of sealants is obvious at high caries risk but information on the benefits of sealing specific to different caries risks is lacking.
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Cochrane Db Syst Rev · Oct 2008
Review Meta AnalysisProcaine treatments for cognition and dementia.
Procaine is a controversial substance which has been used for "antiageing" effects including cognitive improvement for more than 50 years.Preparations which contain procaine as a component are claimed to prevent, reverse and interrupt dementia. Several products are widely promoted and can be purchased "over the counter" outside the US and via the Internet. Procaine preparations are said to be readily available in over 70 countries and to be used by more than 100 million people. ⋯ This review suggests that the evidence for detrimental effects of procaine and its preparations is stronger than the evidence for benefit in preventing and/or treating dementia or cognitive impairment.There is some evidence from older studies that procaine preparations might improve memory in persons without cognitive impairment. However, the clear evidence of side effects suggests that the risks might outweigh the benefits. In the light of this, the strong marketing claims for procaine preparations should be withdrawn until trials of adequate size, duration and quality have been conducted.