Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewAnticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attacks.
People with nonrheumatic atrial fibrillation who have had a transient ischemic attack or a minor ischemic stroke are at risk of recurrent stroke. ⋯ The evidence suggests that anticoagulants are beneficial, without serious adverse effects, for people with nonrheumatic atrial fibrillation and recent cerebral ischaemia.
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Leptospirosis is an infectious disease transmitted by animals. Death occurs in about five per cent of the patients. In clinical practice, doxycycline is widely used for prevention. ⋯ Prophylaxis of leptospirosis may be achieved by administrating doxycycline to soldiers training in endemic areas with a high risk of exposure to leptospirosis. Whether these findings apply to other scenarios or not remains to be proven.
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The role of chemotherapy in the treatment of patients with non-small cell lung cancer was not clear. A systematic review and quantitative meta-analysis was therefore undertaken to evaluate the available evidence from all relevant randomised trials. ⋯ At the outset of this meta-analysis there was considerable pessimism about the role of chemotherapy in the treatment of non-small cell lung cancer. These results offer hope of progress and suggest that chemotherapy may have a role in treating this disease.
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Cochrane Db Syst Rev · Jan 2000
ReviewAnticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attacks.
People with nonrheumatic atrial fibrillation who have had a transient ischemic attack or minor ischemic stroke are at risk of recurrent stroke. ⋯ The evidence from one trial suggests that anticoagulant therapy can benefit people with nonrheumatic atrial fibrillation and recent cerebral ischaemia. Aspirin may be a useful alternative if there is a contraindication to anticoagulant therapy. The risk of adverse events appears to be higher with anticoagulant therapy than aspirin.
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The primary rationale for surgery for disc prolapse is to relieve nerve root irritation or compression due to herniated disc material. Claims of the merits of alternative surgical procedures are made without clear evidence about clinical outcomes. The objective of this review was to assess the effects of surgical interventions for the treatment of lumbar disc prolapse. ⋯ Chemonucleolysis is more effective than placebo and it is less invasive but less effective than surgical disectomy. Surgical discectomy for carefully selected patients with sciatica due to lumbar disc prolapse provides faster relief from the acute attack than conservative management, although any positive or negative effects on the lifetime natural history of the underlying disc disease are unclear.