Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisBed rest for acute uncomplicated myocardial infarction.
Bed rest is prescribed to all patients with acute myocardial infarction (AMI), but to a variable extent. Current guidelines (American College of Cardiology/ American Heart Association) recommend at least 12 hours bed rest in patients with uncomplicated ST-elevation myocardial infarction, however the basis for this recommendation is unclear. ⋯ Bed rest ranging from 2 to 12 days appears to be as safe as longer periods of bed rest. The quality of most trials is unsatisfactory. Current bed rest recommendations are not supported by the existing evidence as the optimal duration of bed rest is unknown. The lack of adequate trials is surprising, considering the large size of several studies to compare effectiveness of drugs on people with AMI.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisOvarian stimulation protocols (anti-oestrogens, gonadotrophins with and without GnRH agonists/antagonists) for intrauterine insemination (IUI) in women with subfertility.
Intrauterine insemination (IUI) combined with ovarian hyperstimulation (OH) has been demonstrated to be an effective form of treatment for subfertile couples. Several ovarian stimulation protocols combined with IUI have been proposed, but it is still not clear which stimulation protocol and which dose is the most cost-effective. ⋯ Robust evidence is lacking but based on the available results gonadotrophins might be the most effective drugs when IUI is combined with ovarian hyperstimulation. When gonadotrophins are applied it might be done on a daily basis. When gonadotrophins are used for ovarian stimulation low dose protocols are advised since pregnancy rates do not differ from pregnancy rates which result from high dose regimen, whereas the chances to encounter negative effects from ovarian stimulation such as multiples and OHSS are limited with low dose gonadotrophins. Further research is needed for each comparison made.
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Based mainly on experimental data that indicates improvement to the cerebral microcirculation, Dan Shen, a herbal medicine, is widely used in the treatment of acute ischaemic stroke in China. ⋯ The methodological quality of all included studies was poor, and reliable conclusions could not be drawn from the present data. Further high-quality randomised controlled trials should be performed.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisEMG biofeedback for the recovery of motor function after stroke.
Electromyographic biofeedback (EMG-BFB) is a technique that is believed to have additional benefit when used with standard physiotherapy for the recovery of motor function in stroke patients. However, evidence from individual trials and previous systematic reviews has been inconclusive. ⋯ Despite evidence from a small number of individual studies to suggest that EMG-BFB plus standard physiotherapy produces improvements in motor power, functional recovery and gait quality when compared to standard physiotherapy alone, combination of all the identified studies did not find a treatment benefit. Overall the results are limited because the trials were small, generally poorly designed and utilised varying outcome measures.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisContracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities.
Contracts are a verbal or written agreement that a patient makes with themselves, with healthcare practitioners, or with carers, where participants commit to a set of behaviours related to the care of a patient. Contracts aim to improve the patients' adherence to treatment or health promotion programmes. ⋯ There is limited evidence that contracts can potentially contribute to improving adherence, but there is insufficient evidence from large, good quality studies to routinely recommend contracts for improving adherence to treatment or preventive health regimens.