CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
-
Review Meta Analysis
Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis.
Arthroscopic surgery for degenerative meniscal tears is a commonly performed procedure, yet the role of conservative treatment for these patients is unclear. This systematic review and meta-analysis evaluates the efficacy of arthroscopic meniscal débridement in patients with knee pain in the setting of mild or no concurrent osteoarthritis of the knee in comparison with nonoperative or sham treatments. ⋯ There is moderate evidence to suggest that there is no benefit to arthroscopic meniscal débridement for degenerative meniscal tears in comparison with nonoperative or sham treatments in middle-aged patients with mild or no concomitant osteoarthritis. A trial of nonoperative management should be the first-line treatment for such patients.
-
Review Meta Analysis
Cognitive impairment and risk of future stroke: a systematic review and meta-analysis.
Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke. ⋯ Baseline cognitive impairment was associated with a significantly higher risk of future stroke, especially ischemic and fatal stroke.
-
Randomized Controlled Trial Multicenter Study
Effect of melatonin on incidence of delirium among patients with hip fracture: a multicentre, double-blind randomized controlled trial.
Disturbance of the sleep-wake cycle is a characteristic of delirium. In addition, changes in melatonin rhythm influence the circadian rhythm and are associated with delirium. We compared the effect of melatonin and placebo on the incidence and duration of delirium. ⋯ In this older population with hip fracture, treatment with melatonin did not reduce the incidence of delirium.