Cochrane Db Syst Rev
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Parkinson's disease is one of the most common neurodegenerative disorders and mitochondrial dysfunction plays an important role in its pathogenesis. Creatine is effective in improving mitochondrial function. It may therefore be useful for slowing the progression of Parkinson's disease. ⋯ The evidence base on the effects of creatine in Parkinson's disease is limited by risk of bias, small sample sizes and short duration of the eligible trials. It does not provide a reliable basis on which treatment decisions can be made. Future well-designed RCTs with larger sample size and long-term follow-up are needed to assess creatine for Parkinson's disease.
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Cochrane Db Syst Rev · Jun 2014
Review Meta AnalysisInformation and communication technology based prompting for treatment compliance for people with serious mental illness.
Non-compliance is a significant problem among people with serious mental disorders, presenting a challenge for mental health professionals. Prompts such as telephone calls, visits, and a posted referral letter to patients are currently used to encourage patient attendance at clinics and/or compliance with medication. More recently, the use of information and communication technology (ICT)-based prompting methods have increased. Methods include mobile text message (SMS - short message service), e-mail or use of any other electronic device with the stated purpose of encouraging compliance. ⋯ The evidence base on the effects of ICT-based prompts is still inconclusive. Data to clarify ICT-based prompting effects are awaited from an ongoing trial, but further well-conducted trials considering the different ICT-based prompts are warranted.
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Cochrane Db Syst Rev · Jun 2014
Review Meta Analysis Comparative StudyExcimer laser refractive surgery versus phakic intraocular lenses for the correction of moderate to high myopia.
Myopia is a condition in which the focusing power (refraction) of the eye is greater than that required for clear distance vision. There are two main types of surgical correction for moderate to high myopia; excimer laser and phakic intraocular lenses (IOLs). Excimer laser refractive surgery for myopia works by removing corneal stroma to lessen the refractive power of the cornea and to bring the image of a viewed object into focus onto the retina rather than in front of it. Phakic IOLs for the treatment of myopia work by diverging light rays so that the image of a viewed object is brought into focus onto the retina rather than in front of the retina. They can be placed either in the anterior chamber of the eye in front of the iris or in the posterior chamber of the eye between the iris and the natural lens. ⋯ The results of this review suggest that, at one year post surgery, phakic IOLs are safer than excimer laser surgical correction for moderate to high myopia in the range of -6.0 to -20.0 D and phakic IOLs are preferred by patients. While phakic IOLs might be accepted clinical practice for higher levels of myopia (greater than or equal to 7.0 D of myopic spherical equivalent with or without astigmatism), it may be worth considering phakic IOL treatment over excimer laser correction for more moderate levels of myopia (less than or equal to 7.0 D of myopic spherical equivalent with or without astigmatism). Further RCTs adequately powered for subgroup analysis are necessary to further elucidate the ideal range of myopia for phakic IOLs. This data should be considered alongside comparative data addressing long-term safety as it emerges.
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Cochrane Db Syst Rev · Jun 2014
Review Comparative StudyPhysiotherapy for Parkinson's disease: a comparison of techniques.
Despite medical therapies and surgical interventions for Parkinson's disease (PD), patients develop progressive disability. The role of physiotherapy is to maximise functional ability and minimise secondary complications through movement rehabilitation within a context of education and support for the whole person. The overall aim is to optimise independence, safety and wellbeing, thereby enhancing quality of life. Trials have shown that physiotherapy has short-term benefits in PD. However, which physiotherapy intervention is most effective remains unclear. ⋯ Considering the small number of participants examined, the methodological flaws in many of the studies, the possibility of publication bias, and the variety of interventions, formal comparison of the different physiotherapy techniques could not be performed. There is insufficient evidence to support or refute the effectiveness of one physiotherapy intervention over another in PD.This review shows that a wide range of physiotherapy interventions to treat PD have been tested . There is a need for more specific trials with improved treatment strategies to underpin the most appropriate choice of physiotherapy intervention and the outcomes measured.