Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2003
ReviewRegular self-examination or clinical examination for early detection of breast cancer.
Breast self-examination and clinical breast examination have been promoted for many years as general screening methods to diagnose breast cancer at an earlier stage in order to decrease morbidity and or mortality. The possible benefits and harms remain unclear. ⋯ Data from two large trials do not suggest a beneficial effect of screening by breast self-examination whereas there is evidence for harms. There were no randomised trials of clinical breast examination. At present, breast self-examination cannot be recommended.
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Olanzapine, an atypical antipsychotic, is used in the treatment of mania both as monotherapy and combined with other medicines. ⋯ Olanzapine is an effective treatment for mania and may be more efficacious than divalproex, though leads to more weight gain. Clinicians should consider both the relative efficacy and the different incidence of specific adverse effects of available drugs.
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Abnormal involuntary movements known as dyskinesias are amongst the most disabling side-effects of levodopa therapy. It is thought that amantadine, an NMDA-receptor antagonist, may reduce dyskinesias in patients with Parkinson's disease without worsening Parkinsonian symptoms. ⋯ Due to lack of evidence it is impossible to determine whether amantadine is a safe and effective form of treatment for levodopa-induced dyskinesias in patients with Parkinson's disease.
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Cochrane Db Syst Rev · Jan 2003
ReviewAnti-inflammatory treatment for carditis in acute rheumatic fever.
Rheumatic heart disease remains the most important cause of acquired heart disease in developing countries. Although the prevention of rheumatic fever and the management of recurrences is well established the optimal management of active rheumatic carditis is still unclear. ⋯ There is no benefit in using corticosteroids or intravenous immunoglobulins to reduce the risk of heart valve lesions in patients with acute rheumatic fever. The antiquity of most of the trials restricted adequate statistical analysis of the data and acceptable assessment of clinical outcomes by current standards. New randomised controlled trials in patients with acute rheumatic fever to assess the effects of corticosteroids such as oral prednisone and intravenous methylprednisone, and other new anti-inflammatory agents are warranted. Advances in echocardiography will allow for more objective and precise assessment of cardiac outcomes.
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Cochrane Db Syst Rev · Jan 2003
ReviewLong acting beta-agonists versus theophylline for maintenance treatment of asthma.
Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. ⋯ Long-acting beta-2 agonists are at least as effective than theophylline in reducing asthma symptoms including night waking and improving lung function. Fewer adverse events occurred in subjects using long-acting beta-2 agonists(salmeterol and formoterol) as compared to theophylline.