Cochrane Db Syst Rev
-
Cochrane Db Syst Rev · Jan 2005
ReviewBotulinum toxin type A versus anticholinergics for cervical dystonia.
Cervical dystonia is the most common form of focal dystonia. It is characterized by involuntary posturing of the head and frequently is associated with neck pain. Disability and social withdrawal are common. Most cases are idiopathic and generally cervical dystonia is a life-long disorder. Botulinum toxin Type A (BtA) is now the first line therapy. Before BtA, anticholinergics were the most widely accepted treatment, so it is important to understand how these two treatments compare. ⋯ The available evidence suggests that BtA injections provide more objective and subjective benefit than trihexyphenidyl to patients with cervical dystonia. We could not draw any conclusions about other anticholinergic drugs. Future trials should explore the role of anticholinergic drugs in patients that do not get benefit with BtA.
-
Influenza is an acute respiratory communicable disease which can cause high morbidity and mortality in an epidemic. Traditional Chinese medicinal herbs following a particular theory may be a potential medicine of choice. ⋯ The small number of included studies and participants, as well as the low quality of most studies, made the evidence far from conclusive for clinical decision making, although traditional Chinese medicinal herbs as a whole seem to be comparatively or more effective compared to different chemical drugs. A certain herbal preparation could not be recommended for there was not enough evidence. More high quality randomised controlled trials (RCTs) with similar interventions are required to strengthen the evidence for the efficacy and safety of certain herbal preparation.
-
Cochrane Db Syst Rev · Jan 2005
ReviewThrombolytic agents for arterial and venous thromboses in neonates.
Clinically symptomatic thromboses are infrequent but serious complications in infants undergoing intensive care. Most are related to central vascular catheters. Symptomatic thrombosis may cause severe morbidity due to irreversible organ damage and also loss of limbs. ⋯ No conclusions could be made as no eligible studies were found. It is time that a randomised controlled trial was performed comparing thrombolytic therapy to heparin therapy to aid neonatologists in the treatment of arterial and venous thromboses.
-
Heart failure is a common and growing health problem. Depression is prevalent among these patients and is associated with an increased risk of mortality, in some, but not all, studies. Depression may increase the risk of recurrent cardiac events and death, either through direct pathophysiological mechanisms such as thrombogenesis or ventricular arrhythmias, or through behavioural mechanisms. Depressed patients are less likely to adhere to their medication regimen and modify their lifestyle appropriately, thereby increasing the likelihood of recurrent cardiac events and death. The effects of psychological interventions for depression in terms of reducing depression and improving prognosis in patients with heart failure are unknown. ⋯ Depression is common among patients with heart failure. Randomised controlled trials of psychological interventions for depression in heart failure patients are needed to investigate the impact of such interventions on depression, quality of life, behavioural CVD risk factors, cardiac morbidity, health economics and mortality, given the paucity of such trials in this area and the increasing prevalence of heart failure.
-
Vitamin C supplementation may help reduce the risk of pregnancy complications like pre-eclampsia, intrauterine growth restriction and maternal anaemia. There is a need to evaluate the efficacy and safety of vitamin C supplementation in pregnancy. ⋯ The data are too few to say if vitamin C supplementation, alone or combined with other supplements, is beneficial during pregnancy. Preterm birth may have been increased with vitamin C supplementation.