Cochrane Db Syst Rev
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Vascular surgeons construct femoro-popliteal bypass grafts, from the groin to the knee, to save limbs that might otherwise require amputation in patients with severe arterial disease, and to improve walking distance in patients with less severe arterial disease. During the operation, the blocked native artery is bypassed using either a section of the patient's own vein (autologous vein), human umbilical vein (HUV), or an artificial graft e.g. Dacron or polytetrafluoroethylene (PTFE). ⋯ There is no clear evidence which type of graft is best for femoro-popliteal grafting. In terms of autologous graft patency, in-situ and reversed vein grafts are equally successful, while HUV performs better than PTFE. A distal vein cuff may improve primary patency for below-knee PTFE femoro-popliteal grafts.
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Cochrane Db Syst Rev · Jan 2000
Review Comparative StudyNedocromil sodium vs. sodium cromoglycate for preventing exercise-induced bronchoconstriction in asthmatics.
Nedocromil sodium and sodium cromoglycate inhaled shortly before exercise appear to reduce the severity of exercise-induced bronchoconstriction. There is some debate over which drug may be more effective. ⋯ No significant differences were evident between the effect of NCS and SCG during the immediate post-exercise period in adults and children with EIB with regards to pulmonary function - specifically maximum percent decrease in FEV1, complete protection, clinical protection, or side effects.
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This systematic review assessed the effect of maximal androgen blockade (MAB) on survival when compared to castration (medical or surgical) alone for patients with advanced prostate cancer. ⋯ MAB produces a modest overall and cancer-specific survival at 5 years but is associated with increased adverse events and reduced quality of life.
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To assess the efficacy of fluoride therapy on bone loss, vertebral and non-vertebral fractures and side effects in postmenopausal women. ⋯ Although fluoride has an ability to increase BMD at lumbar spine, it does not result in a reduction of vertebral fractures. In increasing the dose of fluoride, one increases the risk of non-vertebral fracture and gastrointestinal side effects without any effect on the vertebral fracture rate.
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Most ischaemic strokes are caused by blood clots blocking an artery in the brain. Clot prevention with anticoagulant therapy could have a significant impact on patient survival, disability and recurrence of stroke. ⋯ Immediate anticoagulant therapy in patients with acute ischaemic stroke is not associated with net short- or long-term benefit. The data from this review do not support the routine use of any type of anticoagulant in acute ischaemic stroke.