Cochrane Db Syst Rev
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Evidence supports a role for the NMDA receptors in learning and memory. These can be modulated by the antibiotic D-cycloserine in such a way that the effect of the excitatory transmitter substance glutamate is enhanced. A study on healthy subjects pretreated with scopolamine to mimic Alzheimer's disease showed a positive effect of D-cycloserine at low doses. ⋯ The lack of a positive effect of D-cycloserine on cognitive outcomes in controlled clinical trials with statistical power high enough to detect a clinically meaningful effect means that D-cycloserine has no place in the treatment of patients with Alzheimer's disease.
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Cochrane Db Syst Rev · Jan 2002
ReviewInterventions for helping patients to follow prescriptions for medications.
People who are prescribed self-administered medications typically take less than half the prescribed doses. Efforts to assist patients with adherence to medications might improve the benefits and efficiency of health care, but also might increase its adverse effects. ⋯ The full benefits of medications cannot be realised at currently achievable levels of adherence. Current methods of improving adherence for chronic health problems are mostly complex and not very effective. Innovations to assist patients to follow medication prescriptions are needed.
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Cochrane Db Syst Rev · Jan 2002
ReviewPre-conception and antenatal screening for the fragile site on the X-chromosome.
Fragile X is the most common cause of mental retardation after Down syndrome. It is the commonest inherited cause of mental retardation, and results from a dynamic mutation in a gene on the long arm of the X chromosome. Various strategies are used for prenatal screening. ⋯ No information is available from randomised trials to indicate whether routine pre-conceptual or antenatal screening for fragile X carrier status confers any benefit over testing women thought to be at increased risk.
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Cochrane Db Syst Rev · Jan 2002
ReviewNon-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis.
Chronic radiation cystitis occurs a minimum of three months after completion of pelvic radiotherapy and represents a range of clinical symptoms for which there is as yet no recommended standard management. ⋯ In such a relatively rare condition there are obvious difficulties in identifying sufficient patients to participate in a randomised controlled trial. The number of published reports is a reflection of the degree of medical interest that exists in providing therapeutic solutions for late radiation cystitis. However, in spite of the two studies of level IIA evidence, the absence of randomised controlled trials makes it impossible to draw any firm conclusions.
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Cochrane Db Syst Rev · Jan 2002
ReviewInterventions for acute non-arteritic central retinal artery occlusion.
Acute central retinal artery occlusion 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. ⋯ There is currently not enough evidence to decide which, if any, interventions for acute non-arteritic central retinal artery occlusion would result in any beneficial or harmful effect. Well-designed randomised controlled trials are needed to establish the most effective treatment.