Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2001
ReviewSystemic therapy for treating locoregional recurrence in women with breast cancer.
Between 10% and 35% of women with operable breast cancer will experience an isolated locoregional recurrence following their primary treatment. There is currently no good evidence that adjuvant systemic treatment is effective in this situation and there is no standard treatment for women who have such a recurrence. ⋯ This systematic review of randomised trials provides insufficient evidence to do other than conclude that the most appropriate form of practice for women with loco-regional recurrence of breast cancer is participation in randomised trials of systemic treatment versus observation.
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Eclampsia, the occurrence of a seizure in association with pre-eclampsia, is a rare but serious complication of pregnancy. A number of different anticonvulsants are used to control eclamptic fits and to prevent further seizures. ⋯ Magnesium sulphate is the anticonvulsant of choice for women with eclampsia. Lytic cocktail should be abandoned.
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Menière's disease is characterised by attacks of hearing loss, tinnitus and disabling vertigo. Betahistine is used by many people to reduce the frequency and severity of these attacks but there is conflicting evidence relating to its effects. ⋯ There is insufficient evidence to say whether betahistine has any effect on Menière's disease.
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Pre-operative traction following an acute hip fracture remains standard practice in some hospitals. ⋯ From the evidence available, the routine use of traction (either skin or skeletal) prior to surgery for a hip fracture does not appear to have any benefit. However, the evidence is also insufficient to rule out the potential advantages for traction, in particular for specific fracture types, or to confirm additional complications due to traction use. Further, high quality trials would be required to confirm or refute the absence of benefits of traction.
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: Two recent clinical reports describe an association between statin therapy and a reduction in the occurrence of Alzheimer's disease by as much as 70 %. One report is a cross-sectional analysis of discharges among three hospitals, and the other is a nested case control study drawn from ambulatory patients of general practitioners in the UK. Because neither study is a randomized trial, the association noted between statin therapy and a reduced incidence of Alzheimer's disease may have occurred because other factors, unaccounted for in the studies, may be present (so called bias) and be responsible for the observed association. However, there is an expanding body of biological and epidemiological data that makes it plausible that statin therapy may retard or prevent the pathogenesis and clinical expression of Alzheimer's disease. This review was initiated in order to find other clinical evidence that might support or refute the hypothesized benefit of statin therapy. ⋯ : There is no good evidence to recommend statins for reducing the risk of Alzheimer's disease. There is, however, a growing body of biological, epidemiological, and limited but non-randomized clinical evidence that lowering serum cholesterol may retard the pathogenesis of Alzheimer's disease. Mounting the clinical studies to determine the potential benefit of statin therapy should be a high priority for future research agendas.