Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewChorion villus sampling versus amniocentesis for prenatal diagnosis.
Amniocentesis test results are usually available only after 18 weeks gestation. Chorion villus sampling (CVS) may be performed transabdominally or transvaginally, usually between 10 and 12 weeks gestation. ⋯ The increase in miscarriages after chorion villus sampling compared to amniocentesis appear to be procedure related. Second trimester amniocentesis appears to be safer than chorion villus sampling. The benefits of earlier diagnosis with chorion villus sampling must be set against the greater risk of pregnancy loss.
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Cochrane Db Syst Rev · Jan 2000
ReviewRopinirole versus bromocriptine for levodopa-induced complications in Parkinson's disease.
Long-term levodopa therapy for Parkinson's disease is complicated by the development of motor fluctuations and abnormal involuntary movements. One approach is to add a dopamine agonist at this stage of the disease to reduce the time the patient spends immobile or off and to reduce the dose of levodopa in the hope of reducing such problems in the future. ⋯ Ropinirole is at least as good as bromocriptine in patients with Parkinson's disease with motor complications in terms of improving off time and reducing levodopa dose, without increasing adverse events including dyskinesia. However, these comparitor studies may have been underpowered to detect clinically meaningful differences between the agonists. Further, much larger, phase IV studies are required to examine the efficacy, effectiveness, and safety of all of the dopamine agonists as adjuvant therapy in Parkinson's disease.
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Cochrane Db Syst Rev · Jan 2000
ReviewInhaled short acting beta2-agonist use in asthma: regular vs as needed treatment.
Inhaled beta2-adrenergic agonists delivered by inhalation are very widely used in asthma. There has been much controversy of the use and possible consequences of the use of these agents for regular, as opposed as-needed use in asthma. ⋯ These results support current guidelines. There is little advantage in using short-acting beta2-agonists regularly, and potentially some small clinical disadvantage.
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Cochrane Db Syst Rev · Jan 2000
ReviewEarly amniocentesis versus transabdominal chorion villus sampling for prenatal diagnosis.
A major disadvantage of amniocentesis is that test results are usually available only after 18 weeks gestation. Early amniocentesis can now be done between 9 to 14 weeks gestation. ⋯ Current data suggest that early amniocentesis is associated with a greater risk of spontaneous miscarriage and neonatal talipes compared to transabdominal chorion villus sampling. An increased risk of these complications needs to be weighed against fewer technical difficulties and the possibility of fewer neonatal haemangiomas.
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Cochrane Db Syst Rev · Jan 2000
ReviewAdjuvant chemotherapy for localised resectable soft tissue sarcoma in adults. Sarcoma Meta-analysis Collaboration (SMAC).
Individually, randomised trilas have not shown conclusively whether adjuvant chemotherapy benefits adult patients with localised resectable soft-tissue sarcoma. ⋯ Doxorubicin-based adjuvant chemotherapy appears to significantly improve time to local and distant recurrence and overall recurrence-free survival in adults with localised resectable soft tissue sarcoma. There is some evidence of a trend towards improved overall survival.