The American journal of medicine
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Review Meta Analysis
Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials.
To review the effectiveness of exercise-based cardiac rehabilitation in patients with coronary heart disease. ⋯ This review confirms the benefits of exercise-based cardiac rehabilitation within the context of today's cardiovascular service provision.
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Meta Analysis
Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: a meta-analysis.
To investigate the effects of alpha(2)-adrenergic agonists on perioperative mortality and cardiovascular complications in adults undergoing surgery. ⋯ Alpha-2 adrenergic agonists reduce mortality and myocardial infarction following vascular surgery. During cardiac surgery, they reduce ischemia and may also have effects on mortality and myocardial infarction. Large randomized trials are needed to evaluate these agents during cardiac and vascular surgery.
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Review Meta Analysis
Milk thistle for the treatment of liver disease: a systematic review and meta-analysis.
Milk thistle, an herbal compound, is the dietary supplement taken most frequently by patients with chronic liver disease. We performed a systematic review of the literature to determine the efficacy and safety of this herb for the treatment of liver disease. ⋯ Treatment with milk thistle appears to be safe and well tolerated. We found no reduction in mortality, in improvements in histology at liver biopsy, or in biochemical markers of liver function among patients with chronic liver disease. Data are too limited to exclude a substantial benefit or harm of milk thistle on mortality, and also to support recommending this herbal compound for the treatment of liver disease.
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Meta Analysis
The effect of interventions to prevent cardiovascular disease in patients with type 2 diabetes mellitus.
Cardiovascular complications account for over 50% of mortality among patients with type 2 diabetes mellitus. We quantify the cardiovascular benefit of lowering cholesterol, blood pressure, and glucose levels in these patients. ⋯ The evidence from these clinical trials demonstrates that lipid and blood pressure lowering in patients with type 2 diabetes is associated with substantial cardiovascular benefits. Intensive glucose lowering is essential for the prevention of microvascular disease, but improvements in cholesterol and blood pressure levels are central to reducing cardiovascular disease in these patients.
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Although antidepressants are often used for preventing chronic headache, their effectiveness is uncertain. ⋯ Antidepressants are effective in preventing chronic headaches. Whether this is independent of depression and whether there are differences in efficacy by class of agent needs further study.