Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2001
ReviewCabergoline versus bromocriptine for levodopa-induced complications in Parkinson's disease.
Long term levodopa therapy in Parkinson's disease is associated with the development of motor complications including abnormal involuntary movements and a shortening response to each dose (wearing off phenomenon). It is thought that dopamine agonists can reduce the duration of immobile off periods and the need for levodopa therapy whilst maintaining or improving motor impairments and only minimally increasing dopaminergic adverse events. ⋯ Cabergoline produces similar benefits to bromocriptine in off time reduction, motor impairment and disability ratings, and levodopa dose reduction over the first three months of therapy. Dyskinesia and confusion were increased with cabergoline but otherwise the frequency of adverse events and withdrawals from treatment were similar with the two agonists.
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Cochrane Db Syst Rev · Jan 2001
ReviewTroleandomycin as an oral corticosteroid steroid sparing agent in stable asthma.
Patients with chronic severe asthma are often dependent on the long term prescription of oral corticosteroids. The use of steroids is associated with serious side effects. Physicians treating such patients continue to search for alternative therapies that reduce the need for chronic dosing with oral steroids. troleandomycin is a compound that is established as an effective antibiotic but may also have non antibacterial actions that may be useful in the treatment of asthma. ⋯ There is insufficient evidence to support the use of troleandomycin in the treatment of steroid dependent asthma.
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Cochrane Db Syst Rev · Jan 2001
ReviewTiclopidine versus oral anticoagulation for coronary stenting.
A 2-4 week course of ticlopidine plus aspirin following coronary stenting is considered effective in preventing thrombotic occlusion of the stented vessel and safe in regards to bleeding and peripheral vascular complications. However, rare, although potentially life-threatening haematological complications have been reported with this drug regimen. ⋯ Ticlopidine plus aspirin after coronary stenting is effective in reducing the risk of the revascularization, non fatal myocardial infarction and bleeding complications when compared with oral anticoagulants. No effect is observed on total mortality. However, the haematological side effects of ticlopidine are still a matter of concern, and strict monitoring of blood-cell counts is recommended. Physicians should also be aware of the possibility of rare although potentially life-threatening complications such as TTP
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Cochrane Db Syst Rev · Jan 2001
ReviewInternal fixation implants for intracapsular proximal femoral fractures in adults.
Numerous different implants with screws, pins and side plates have been used for the internal fixation of intracapsular hip fractures. ⋯ No clear conclusions can be made on the choice of implant for internal fixation of intracapsular fractures from the available evidence within randomised trials.
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There have been many randomised trials of adjuvant tamoxifen among women with early breast cancer, and an updated overview of their results is presented. ⋯ For women with tumours that have been reliably shown to be ER-negative, adjuvant tamoxifen remains a matter for research. However, some years of adjuvant tamoxifen treatment substantially improves the 10-year survival of women with ER-positive tumours and of women whose tumours are of unknown ER status, with the proportional reductions in breast cancer recurrence and in mortality appearing to be largely unaffected by other patient characteristics or treatments.