Cochrane Db Syst Rev
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Cochrane Db Syst Rev · May 2010
Review Meta AnalysisGraft type for femoro-popliteal bypass surgery.
Femoro-popliteal bypass is implemented to save limbs that might otherwise require amputation, in patients with ischaemic rest pain or tissue loss; and to improve walking distance in patients with severe life-limiting claudication. Contemporary practice involves using autologous vein, polyterafluoroethylene (PTFE) or Dacron as a bypass conduit.This is an update of a Cochrane review first published in 1999 and previously updated in 2002. ⋯ There was a clear primary patency benefit for autologous vein when compared to synthetic materials for above knee bypasses. In the long term (five years) Dacron confers a small primary patency benefit over PTFE for above knee bypass. PTFE with a vein cuff improved primary patency when compared to PTFE alone for below knee bypasses. Further randomised data is needed to ascertain whether this information translates into improvement in limb survival.
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Cochrane Db Syst Rev · May 2010
Review Meta AnalysisSpeech and language therapy for aphasia following stroke.
Aphasia is an acquired language impairment following brain damage which affects some or all language modalities: expression and understanding of speech, reading and writing. Approximately one-third of people who have a stroke experience aphasia. ⋯ This review shows some indication of the effectiveness of SLT for people with aphasia following stroke. We also observed a consistency in the direction of results which favoured intensive SLT over conventional SLT, though significantly more people withdrew from intensive SLT than conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be as effective as the provision of SLT by a professional. There was insufficient evidence to draw any conclusions in relation to the effectiveness of one SLT approach over another.
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Cochrane Db Syst Rev · May 2010
Review Meta AnalysisRadiotherapy for neovascular age-related macular degeneration.
Radiotherapy has been proposed as a treatment to prevent new vessel growth in people with neovascular age-related macular degeneration (AMD). ⋯ This review currently does not provide convincing evidence that radiotherapy is an effective treatment for neovascular AMD. If further trials are to be considered to evaluate radiotherapy in AMD then adequate masking of the control group must be considered.
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Cochrane Db Syst Rev · May 2010
Review Meta AnalysisChemotherapy and supportive care versus supportive care alone for advanced non-small cell lung cancer.
Since our individual patient data (IPD) meta-analysis of supportive care and chemotherapy for non-small cell lung cancer (NSCLC), published in 1995, many trials have been completed. We have carried out an updated IPD meta-analysis to assess newer regimens and determine conclusively the effect of chemotherapy. ⋯ All trials were of good methodological quality with no risk of bias. This meta-analysis of chemotherapy in the supportive care setting demonstrates that chemotherapy improves overall survival in all patients with advanced NSCLC. Patients who are fit enough and wish to receive it should be offered chemotherapy.