Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2009
ReviewThrombophilia testing for prevention of recurrent venous thromboembolism.
Tests for thrombophilia are being performed on a large scale in people after venous thromboembolism (VTE) even though the benefits of testing are still subject to debate. The most important benefit would be a reduction in the risk of recurrent VTE due to the use of additional prophylactic measures. ⋯ There are currently no randomized controlled trials or controlled clinical trials that have assessed the benefit(s) of testing for thrombophilia on the risk of recurrent VTE.
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Cochrane Db Syst Rev · Jan 2009
ReviewVision screening of older drivers for preventing road traffic injuries and fatalities.
Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer generation passes retirement age. As older adults make up an increasing proportion of the population, they are an important consideration when designing future evidence-based traffic safety policies, particularly those that lead to restrictions or cessation of driving. Research has shown that cessation of driving among older drivers can lead to negative emotional consequences such as loss of independence and depression. Those older adults who continue to drive tend to do so less frequently than other demographic groups and are more likely to be involved in a road traffic crash, probably due to what is termed the 'low mileage bias'. There is universal agreement among researchers that vision plays a significant role in driving performance, and that there are age-related visual changes. Vision testing of all drivers, and in particular of older drivers, is therefore an important road safety issue. The components of visual function essential for driving are acuity, field, depth perception and contrast sensitivity, which are currently not fully measured by licensing agencies. Furthermore, it is not known how effective vision screening tools are, and current vision screening regulations and cut-off values required to pass a licensing test vary from country to country. There is, therefore, a need to develop evidence-based tools for vision screening for driving, thereby increasing road safety. ⋯ Most countries require a vision screening test for the renewal of an individual's driver's license. There is, however, insufficient evidence to assess the effect of vision screening tests on subsequent motor vehicle crash reduction. There is a need to develop valid and reliable tools of vision screening that can predict driving performance.
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Cochrane Db Syst Rev · Jan 2009
ReviewInterventions for acute non-arteritic central retinal artery occlusion.
Acute central retinal artery occlusion (CRAO) occurs as a sudden interruption of the blood supply to the retina and results in an almost complete loss of vision in the affected eye. There is no generally agreed treatment regimen although a number of therapeutic interventions have been proposed. ⋯ The included studies in this review were small and from single centres. Neither study was completely clear about it's method of treatment allocation. One study described the use of pentoxifylline tablets (three 600 mg tablets daily) and the other the use of enhanced external counterpulsation (EECP) combined with haemodilution. Both studies indicated improved retinal perfusion in the non-control group but neither showed an improvement in vision. Large, well-designed RCTs are still required to establish the most effective treatment for acute CRAO. These studies should be looking at factors important to the patient i.e. improved vision with acceptable risk/side-effects.
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Cochrane Db Syst Rev · Jan 2009
ReviewWITHDRAWN: Interventions for tears of the rotator cuff in adults.
Tears of the rotator cuff tendons, which surround the joints of the shoulder, are one of the most common causes of pain and disability in the upper extremity. ⋯ There is little evidence to support or refute the efficacy of common interventions for tears of rotator cuff in adults. As well as the need for further well designed clinical trials, uniform methods of defining interventions for rotator cuff tears and validated outcome measures are also essential.
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Cochrane Db Syst Rev · Jan 2009
ReviewWITHDRAWN: Bioresorbable fixation devices for musculoskeletal injuries in adults.
Bioresorbable implants for musculoskeletal injuries involving bone and ligaments in adults might have significant advantages compared to the conventionally used non-resorbable metal implants because they lead to a gradual transfer of the mechanical load from the implant to the healing bone and do not require a secondary removal operation. Tissue reactions may present a problem and bioresorbable screws are mechanically not as strong as their metal counterparts. ⋯ In a selected group of compliant patients with simple fractures, the use of bioresorbable fixation devices might be advantageous.